NPIMap

Organization Active NPI

Tattnall Hospital Company, LLC

Doing business as Optim Medical Center Tattnall Sylvania

  • Orthopaedic Surgery Physician
  • Sylvania, GA
National Provider Identifier
1386455376
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
TATTNALL HOSPITAL COMPANY, LLC
Doing business as
Optim Medical Center Tattnall Sylvania
Practice address
209 Mims Rd Ste a
Sylvania, GA 30467-1994
Phone
(912) 564-5236
Fax
(844) 570-7714
NPI assigned
Jan 17, 2025
Last updated
Jan 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Authorized official

Name
David Alex Villa
Title
Ceo
Phone
(912) 629-7797

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X NU
Orthopaedic Surgery Physician 207X00000X NU Primary
Physical Medicine & Rehabilitation Physician 208100000X NU
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X NU
Pain Medicine (Psychiatry & Neurology) Physician 2084P2900X NU
Surgery Physician 208600000X NU
Pain Medicine Physician 208VP0000X NU

Addresses

Primary practice location

209 Mims Rd Ste a
Sylvania, GA 30467-1994

Mailing address

440 Mall Blvd Ste C
Savannah, GA 31406-4868
Phone (912) 644-3340

Other names 1

  • Optim Medical Center Tattnall Sylvania Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080915000167 GA Part B Supplier - Clinic/Group Practice 6204907124 Receives reassigned benefits from 63 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Reidsville, GA; Swainsboro, GA; Richmond Hill, GA; Rincon, GA; Sandersville, GA; Savannah, GA; Statesboro, GA; Sylvania, GA…

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2053511Tattnall Hospital Company, LLC209 Mims Road, Sylvania, GA 30467Certificate of waiverJan 31, 2027

National Provider Directory

National Provider Directory
Tax ID family
Tattnall Medical Group21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations

110 E Tollison St
Baxley, GA 31513
Phone (912) 367-5486

1111 Glynco Pkwy
Ste 30A
Brunswick, GA 31525
Phone (912) 342-7112

1000 N Veterans Blvd
#B
Glennville, GA 30427
Phone (912) 654-4599

60 Exchange St
Ste B1
Richmond Hill, GA 31324
Phone (912) 756-2273

501 Sparta Rd
Ste 3
Sandersville, GA 31082
Phone (478) 272-3140

2317 E 1st St
Vidalia, GA 30474
Phone (912) 537-0888

16 Okatie Center Blvd S
Ste 201
Okatie, SC 29909
Phone (843) 476-4702

Practitioners & affiliated clinicians

Practitioners 67

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1737072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1386455376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 MALL BLVD STE C",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064868",
            "telephone_number": "912-644-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MIMS RD STE A",
            "city": "SYLVANIA",
            "state": "GA",
            "postal_code": "304671994",
            "telephone_number": "912-564-5236",
            "fax_number": "844-570-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TATTNALL HOSPITAL COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-17",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "VILLA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ALEX",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-629-7797"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optim Medical Center Tattnall Sylvania",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sylvania, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.