Individual provider Active NPI

Mark Wesley Loeffler, PA

  • Physician Assistant
  • Bainbridge, GA
National Provider Identifier
1770309262
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13899 Issued in GA
Practice address
303 Country Club Rd
Bainbridge, GA 39819-6520
Phone
(229) 254-8330
NPI assigned
Nov 29, 2024
Last updated
Apr 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13899 GA Primary

Addresses

Primary practice location

303 Country Club Rd
Bainbridge, GA 39819-6520

Mailing address

303 Country Club Rd
Bainbridge, GA 39819-6520

Other practice location 1

350 Hospital Dr
Macon, GA 31217-3838
Phone (478) 765-4155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260521004756 GA Practitioner - Physician Assistant 0648740407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

350 Hospital Dr
Macon, GA 31217-3838
Phone (478) 765-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
13899GAMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1732838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776902400000",
    "number": "1770309262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 COUNTRY CLUB RD",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398196520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 COUNTRY CLUB RD",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398196520",
            "telephone_number": "229-254-8330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312173838",
            "country_code": "US",
            "telephone_number": "478-765-4155",
            "fax_number": "478-765-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOEFFLER",
        "first_name": "MARK",
        "middle_name": "WESLEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-29",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge, GA

Sources for this page

Verify at the official NPI Registry.