Organization Active NPI

Colquitt Regional Cardiology, LLC

  • Cardiovascular Disease Physician
  • Moultrie, GA
National Provider Identifier
1336570191
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
COLQUITT REGIONAL CARDIOLOGY, LLC
Practice address
1 Sweet Bay CT
Moultrie, GA 31768-6756
Phone
(229) 890-5305
Fax
(229) 890-5307
NPI assigned
Dec 4, 2013
Last updated
Sep 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
COLQUITT REGIONAL MEDICAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
James L Matney
Title
Ceo
Phone
(229) 985-3420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

1 Sweet Bay CT
Moultrie, GA 31768-6756

Mailing address

PO Box 2317
Moultrie, GA 31776-2317
Phone (229) 502-9685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140306000571 GA Part B Supplier - Clinic/Group Practice 8426288796 Practice locations: Moultrie, GA

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756857600000",
    "number": "1336570191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2317",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317762317",
            "telephone_number": "229-502-9685",
            "fax_number": "229-890-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SWEET BAY CT",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317686756",
            "telephone_number": "229-890-5305",
            "fax_number": "229-890-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLQUITT REGIONAL CARDIOLOGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLQUITT REGIONAL MEDICAL, INC.",
        "enumeration_date": "2013-12-04",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A",
        "authorized_official_last_name": "MATNEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "229-985-3420"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moultrie, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.