NPIMap

Individual provider Active NPI

Darrell Shawn Surratt, MD

  • Family Medicine Physician
  • Bainbridge, GA
National Provider Identifier
1972570943
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
055984 Issued in GA
Practice address
603 Wheat Ave
Suite 700
Bainbridge, GA 39819-4360
Phone
(229) 243-8462
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 055984 GA Primary

Addresses

Primary practice location

603 Wheat Ave
Suite 700
Bainbridge, GA 39819-4360

Mailing address

603 Wheat Ave
Suite 700
Bainbridge, GA 39819-4360
Phone (229) 243-8462

Other identifiers 2

IdentifierTypeStateIssuer
840736398AMedicaidGA
055984OtherGAMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050628000722 GA Practitioner - Family Practice 7214972405 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southland Consolidated Emergency Services LLCGroup PAC ID 2860792066, 68 clinicians
Port Medical Management IncGroup PAC ID 8729418454, 3 clinicians
Landk Chiropractic Services LLCGroup PAC ID 5193902518, 3 clinicians

Practice addresses (Care Compare)

1500 E Shotwell St
Bainbridge, GA 39819-4256
Phone (229) 246-3500

920 S W St
Bainbridge, GA 39819-4581
Phone (229) 246-8850

922 S W St
Bainbridge, GA 39819-4581
Phone (229) 248-8499

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Bainbridge, GA, CCN 117151
  • Archbold Home Health Services Home health agency, Thomasville, GA, CCN 117024
  • Gentiva Hospice, Bainbridge, GA, CCN 111556
  • Georgia Hospice Care Hospice, Albany, GA, CCN 111773
  • Memorial Hospital and Manor Hospital, Bainbridge, GA, CCN 110132
  • Donalsonville Hospital Inc Hospital, Donalsonville, GA, CCN 110194
  • Memorial Manor Nursing Home Nursing home, Bainbridge, GA, CCN 115711

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
055984GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
L&K Chiropractic Services LLC CurrentSince May 26, 2017 Accepting new patients
Southland Bainbridge Hospitalist Group, LLC CurrentSince Dec 1, 2021 Accepting new patients
Southland Consolidated Emergency Services, LLC CurrentSince Oct 1, 2019 Accepting new patients
Port Medical Management Inc Family Medicine CurrentSince Apr 20, 2020 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

922 S West St
Bainbridge, GA 39819
Phone (229) 248-8499

920 S West St
Bainbridge, GA 39819
Phone (229) 246-8850

1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100

4 Medical Dr
Elberton, GA 30635
Phone (706) 213-2527

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

Organizations & group practices 5

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505260800000",
    "number": "1972570943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 WHEAT AVE",
            "address_2": "SUITE 700",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194360",
            "telephone_number": "229-243-8462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 WHEAT AVE",
            "address_2": "SUITE 700",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194360",
            "telephone_number": "229-243-8462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURRATT",
        "first_name": "DARRELL",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2017-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "055984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "840736398A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "055984",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge, GA

Sources for this page

Verify at the official NPI Registry.