NPIMap

Organization Active NPI

Tattnall Hospital Company, LLC

Doing business as Optim Primary Care- Glennville

  • Rural Health Clinic/Center
  • Glennville, GA
National Provider Identifier
1972762508
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
TATTNALL HOSPITAL COMPANY, LLC
Doing business as
Optim Primary Care- Glennville
Practice address
1000B North Veterans Blvd
Glennville, GA 30427-8603
Phone
(912) 654-4599
Fax
(912) 654-4648
NPI assigned
Jun 9, 2008
Last updated
Jan 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Authorized official

Name
Mr. David Alex Villa
Title
Ceo
Phone
(912) 629-7797

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

1000B North Veterans Blvd
Glennville, GA 30427-8603

Mailing address

440 Mall Blvd Ste C
Savannah, GA 31406-4868
Phone (912) 644-3340

Other names 1

  • Optim Primary Care- Glennville Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080915000167 GA Part B Supplier - Clinic/Group Practice 6204907124 Receives reassigned benefits from 63 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Reidsville, GA; Swainsboro, GA; Richmond Hill, GA; Rincon, GA; Sandersville, GA; Savannah, GA; Statesboro, GA; Sylvania, GA…
O20080915000590 GA Part A Provider - Rural Health Clinic 6204907124 Practice locations: Glennville, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972762508. Details of each certification follow.

Rural health clinic certification: CCN 118511

Legal name
TATTNALL HOSPITAL COMPANY LLC
Doing business as
OPTIM PRIMARY CARE-GLENNVILLE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 26, 2006
Last certification
Mar 2, 2022
Ownership / control type
1B
Most recent change of ownership
Feb 25, 2008 (1 total)
Organization structure
LLCProprietary
Enrollment address
1000 N Veterans Blvd
Ste B
Glennville, GA 30427-8603
Related CCNs
111323

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

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Tattnall Medical Group21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Locations

380A Cedar St
Metter, GA 30439
Phone (912) 685-3992

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Bradley a Heiges Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2009
SP Holdco I Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Sep 1, 2017 50.38%
National Surgical Hospitals, LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Sep 1, 2017 50.38%
Jennifer B Baldock Individual Corporate OfficerOfficer Sep 1, 2019
Charles M Spivey Individual 5% Or Greater Indirect Ownership Interest Feb 22, 2016
Bcpe Seminole Holdings, LP Organization, Boston, MA 5% Or Greater Indirect Ownership Interest Sep 1, 2017 33.86%
Aurora Resources, LLC Organization, Gainesville, FL LLC 5% Or Greater Indirect Ownership Interest Jul 20, 2018 6.49%
Tattnall Chatham, LP Organization, Savannah, GA 5% Or Greater Direct Ownership Interest Jun 1, 2015 49.61%
Surgery Partners Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Sep 1, 2017 50.38%
Community Hospital Holding Company, LLC Organization, Brentwood, TN LLC 5% Or Greater Direct Ownership Interest Jul 1, 2010 50.39%
Surgery Center Holdings Inc Organization, Brentwood, TN Corporation, Chain home office 5% Or Greater Indirect Ownership Interest Sep 1, 2017 50.38%
David Alex Villa Individual W-2 Managing EmployeeCeo Oct 1, 2024
Operational/Managerial ControlCeo Oct 1, 2024
Bradley R Owens Individual OtherNational Group President and Chain Dec 2, 2019
NSH Georgia Inc Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Sep 1, 2017 50.38%
Heiges-Chatham, Inc Organization, Savannah, GA Corporation 5% Or Greater Indirect Ownership Interest Jul 13, 2018 5.59%
Surgery Center Holdings LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Sep 1, 2017 50.38%

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Optim Medical Center - TattnallReidsville, GA, CCN 11Z323 Hospital Operational/Managerial Control Feb 25, 2008

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 23

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

  • Screven County Family Health Center, LLC

    dba Optim Primary Care - Sylvania

    • Rural Health Clinic/Center
    • Sylvania, GA
    • NPI 1841432044

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Screven County Hospital LLC

    dba Optim Primary Care Millen

    • Rural Health Clinic/Center
    • Millen, GA
    • NPI 1033428214

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Screven County Hospital LLC

    dba Optim Medical Center - Screven

    • Medicare Defined Swing Bed Hospital Unit
    • Sylvania, GA
    • NPI 1083915524

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Screven County Hospital, LLC

    dba Optim Medical Center - Screven

    • Critical Access Hospital
    • Sylvania, GA
    • NPI 1225339898

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Tattnall Hospital Company LLC

    dba Optim Medical Center - Tattnall

    • Medicare Defined Swing Bed Hospital Unit
    • Reidsville, GA
    • NPI 1740440932

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, Heiges-Chatham, Inc, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc, Tattnall

    CMS ownership
  • Tattnall Hospital Company, LLC

    dba Optim Primary Care Metter

    • Rural Health Clinic/Center
    • Metter, GA
    • NPI 1285132415

    Aurora Resources, LLC, Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, Heiges-Chatham, Inc, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery

    CMS ownership
  • Tattnall Hospital Company, LLC

    dba Optim Primary Care-Reidsville

    • Rural Health Clinic/Center
    • Reidsville, GA
    • NPI 1285893818

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, Heiges-Chatham, Inc, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc, Tattnall

    CMS ownership
  • Tattnall Hospital Company, LLC

    dba Optim Medical Center - Tattnall

    • Critical Access Hospital
    • Reidsville, GA
    • NPI 1790942381

    Bcpe Seminole Holdings, LP, Community Hospital Holding Company, LLC, Heiges-Chatham, Inc, National Surgical Hospitals, LLC, NSH Georgia Inc, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc, Tattnall

    CMS ownership
  • Animas Surgical Hospital, LLC

    dba Animas Surgical Hospital

    • General Acute Care Hospital
    • Durango, CO
    • NPI 1508842964

    Bcpe Seminole Holdings, LP, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Arizona Spine and Joint Hospital LLC
    • General Acute Care Hospital
    • Mesa, AZ
    • NPI 1396745832

    Bcpe Seminole Holdings, LP, National Surgical Hospitals, LLC, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • Brazos Valley Physicians Organization,Mso-LLC

    dba The Physicians Pain and Spine Centre

    • General Acute Care Hospital
    • Bryan, TX
    • NPI 1801817135

    National Surgical Hospitals, LLC, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
  • CMSC, LLC

    dba Great Falls Clinic Hospital

    • General Acute Care Hospital
    • Great Falls, MT
    • NPI 1639109978

    Bcpe Seminole Holdings, LP, SP Holdco I Inc, Surgery Center Holdings Inc, Surgery Center Holdings LLC, Surgery Partners Inc

    CMS ownership
View all 23

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768348800000",
    "number": "1972762508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 MALL BLVD STE C",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064868",
            "telephone_number": "912-644-3340",
            "fax_number": "912-644-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000B NORTH VETERANS BLVD",
            "city": "GLENNVILLE",
            "state": "GA",
            "postal_code": "304278603",
            "telephone_number": "912-654-4599",
            "fax_number": "912-654-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TATTNALL HOSPITAL COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A",
        "authorized_official_last_name": "VILLA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ALEX",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-629-7797",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optim Primary Care- Glennville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glennville, GA

Sources for this page

Verify at the official NPI Registry.