NPIMap

Organization Active NPI

Georgia Infectious Disease Consultants

  • Infectious Disease Physician
  • Waycross, GA
National Provider Identifier
1902374911
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
GEORGIA INFECTIOUS DISEASE CONSULTANTS
Practice address
1900 Tebeau St
Waycross, GA 31501-6357
Phone
(904) 398-5614
Fax
(904) 398-5617
NPI assigned
Nov 7, 2018
Last updated
Jan 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Authorized official

Name
Bridget Roberts
Title
Ceo
Phone
(904) 398-5614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

1900 Tebeau St
Waycross, GA 31501-6357

Mailing address

2122 University Blvd S
Jacksonville, FL 32216-8937
Phone (904) 398-5614

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190306000664 GA Part B Supplier - Clinic/Group Practice 3779822952 Receives reassigned benefits from 4 practitioners
Practice locations: Waycross, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 45

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 45

NPI Registry JSON

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768262400000",
    "number": "1902374911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168937",
            "telephone_number": "904-398-5614",
            "fax_number": "904-398-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 TEBEAU ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016357",
            "telephone_number": "904-398-5614",
            "fax_number": "904-398-5617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA INFECTIOUS DISEASE CONSULTANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-07",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-398-5614"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2026; 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.