South Georgia Medical Services
Organization Active NPI Family Medicine Physician · Homerville, GA
NPI 1720524580 · NPPES record last updated Jan 17, 2017
Key facts
- NPI
- 1720524580
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- SOUTH GEORGIA MEDICAL SERVICES
- Practice address
- 380 N Church St
Homerville, GA 31634-2452 - Phone
- (912) 487-1737
- Fax
- (912) 487-1739
- NPI assigned
- Jan 17, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Charles A Semones, MD
- Title
- Owner
- Phone
- (912) 487-1737
Practitioners 5
-
Charles Semones, M.D.
-
Betsy Daugharty Clifton, FNP-C
-
Carla Marie Kendrick-Brown, PHYSICIAN ASSISTANT
-
Georgia Griffis, PA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170419001559 | GA | Part B Supplier - Clinic/Group Practice | 8426334889 |
Receives reassigned benefits from 4 practitioners Practice locations: Homerville, GA |
National Provider Directory
Locations
30 W Forest Ave
Ste B
Homerville, GA 31634
380 N Church St
Homerville, GA 31634
Phone (912) 487-1737
120 Broadway
Fl 35
New York, NY 10271
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
380 N Church St
Homerville, GA 31634-2452
Mailing address
380 N Church St
Homerville, GA 31634-2452
Phone (912) 487-1737
Other providers in Homerville, GA
- Shannon D Smith D. C P.C
- Shuman Healthcare of Homerville
- Stephanie Rena Sloan
- Anita H Smith
- Shannon Davis Smith
- Southern Healthcare Systems LLC
- Southland Clinch Emergency Medical Services, LLC
- Nancy Elizabeth Strickland
- Joy Sumner
- Suwannee River Medical
All providers in Homerville, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.