NPIMap

Organization Active NPI

South Georgia Medical Center Inc

Doing business as SGMC Health Lanier

  • Medicare Defined Swing Bed Hospital Unit
  • Lakeland, GA
National Provider Identifier
1851167274
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
SOUTH GEORGIA MEDICAL CENTER INC
Doing business as
SGMC Health Lanier
SGMC Lanier Campus
Practice address
116 W Thigpen Ave
Lakeland, GA 31635-1011
Phone
(229) 433-8440
NPI assigned
Nov 27, 2023
Last updated
Nov 4, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH GEORGIA MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Authorized official

Name
Olaf Faeskorn
Title
VP Revenue Cycle
Phone
(229) 259-4749

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X NU Primary

Addresses

Primary practice location

116 W Thigpen Ave
Lakeland, GA 31635-1011

Mailing address

PO Box 9
Valdosta, GA 31603-0009

Other names 2

  • SGMC Health Lanier Doing business as
  • SGMC Lanier Campus Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240322004363 GA Part A Provider - Critical Access Hospital 1052764677 Practice locations: Lakeland, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851167274. Details of each certification follow.

Hospital certification: CCN 11Z326

Legal name
SOUTH GEORGIA MEDICAL CENTER INC
Organization structure
CorporationNon-profit
Incorporated
Nov 9, 2021 in GA
Enrollment address
116 W Thigpen Ave
Lakeland, GA 31635-1011
Hospital Swing-Bed Unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
South Georgia Medical Center Inc8 organizations share this tax ID, including this one
Part of
South Georgia Medical Center Inc

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Ronnie Dean Individual Corporate OfficerCeo Nov 8, 2019
W-2 Managing EmployeeCeo Nov 8, 2019
South Georgia Medical Center Inc Organization, Valdosta, GA Created for acquisition, Corporation, Non-profit 5% Or Greater Direct Ownership Interest Nov 1, 2023 100%
John Moore Individual Corporate OfficerCfo Jul 19, 2021
W-2 Managing EmployeeCfo Jul 19, 2021
Julie Hodges Individual Corporate OfficerController Jul 6, 2015
W-2 Managing EmployeeController Jul 6, 2015

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
South Georgia Medical Center IncLakeland, GA, CCN 111326 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2023
South Georgia Medical Center IncNashville, GA, CCN 110234 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2023
South Georgia Medical Center IncValdosta, GA, CCN 11T122 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2023
South Georgia Medical Center IncNashville, GA, CCN 11S234 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2023
South Georgia Medical Center IncLakeland, GA, CCN 115707 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Nov 1, 2023

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1851167274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316030009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W THIGPEN AVE",
            "city": "LAKELAND",
            "state": "GA",
            "postal_code": "316351011",
            "telephone_number": "229-433-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GEORGIA MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH GEORGIA MEDICAL CENTER INC",
        "enumeration_date": "2023-11-27",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "FAESKORN",
        "authorized_official_first_name": "OLAF",
        "authorized_official_title_or_position": "VP REVENUE CYCLE",
        "authorized_official_telephone_number": "229-259-4749"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SGMC Health Lanier",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SGMC Lanier Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeland, GA

Sources for this page

Verify at the official NPI Registry.