Organization Active NPI

South Georgia Emergency Medicine Associates PC

  • Emergency Medicine Physician
  • Thomasville, GA
National Provider Identifier
1386903649
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SOUTH GEORGIA EMERGENCY MEDICINE ASSOCIATES PC
Practice address
915 Gordon Ave
Thomasville, GA 31792-6614
Phone
(229) 228-2000
Fax
(386) 274-7801
NPI assigned
May 8, 2012
Last updated
Mar 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Authorized official

Name
Winston Clark Connell Jr., MDNPI 1144370206
Title
Cfo
Phone
(229) 224-1207

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

915 Gordon Ave
Thomasville, GA 31792-6614

Mailing address

202 N Crawford St
Thomasville, GA 31792-5123
Phone (229) 290-7459

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120720000457 GA Part B Supplier - Clinic/Group Practice 4880850775 Receives reassigned benefits from 167 practitioners
Practice locations: Thomasville, GA; Valdosta, GA

National Provider Directory

National Provider Directory

Locations

121 N Love St
Thomasville, GA 31792

202 N Crawford St
Thomasville, GA 31792
Phone (229) 226-1353

Practitioners & affiliated clinicians

Practitioners 184

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 184

NPI Registry JSON

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1386903649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N CRAWFORD ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925123",
            "telephone_number": "229-290-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 GORDON AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926614",
            "telephone_number": "229-228-2000",
            "fax_number": "386-274-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GEORGIA EMERGENCY MEDICINE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "CONNELL",
        "authorized_official_first_name": "WINSTON",
        "authorized_official_middle_name": "CLARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-224-1207",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.