Active NPI
Amelia Medical Services, LLC
- Primary Care Clinic/Center
- Kingsland, GA
National Provider Identifier
1982910048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- License
- 031289
- Legal business name
- AMELIA MEDICAL SERVICES, LLC
- Practice address
- 1481 Hwy 40 E
Kingsland, GA 31548-6507 - Phone
- (912) 729-2821
- Fax
- (912) 729-2823
- NPI assigned
- Aug 27, 2010
- Organization subpart
- Yes
- Parent organization
- AMELIA MEDICAL SERVICES, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Daniel J. Matricia, D.O.
- Title
- Owner
- Phone
- (912) 729-2821
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 031289 | GA | Primary |
| Urgent Care Clinic/Center | 261QU0200X |
Addresses
Primary practice location
1481 Hwy 40 E
Kingsland, GA 31548-6507
Mailing address
1481 Hwy 40 E
Kingsland, GA 31548-6507
Phone (912) 729-2821
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 031289 | Other | GA | GA MEDICAL LICENSE |
| 1912972530 | Other | GA | NPI - MATRICIA |
Other names 1
- Amelia Medical Care, Kingsland
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140924001378 | GA | Part B Supplier - Clinic/Group Practice | 1052530029 |
Receives reassigned benefits from 7 practitioners 1 other NPI on this enrollment Practice locations: Folkston, GA |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Amelia Medical Services LLC
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Family Medicine Physician
- Folkston, GA
- NPI 1063825842
Practitioners & affiliated clinicians
Practitioners 7
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282867200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1982910048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1481 HWY 40 E",
"city": "KINGSLAND",
"state": "GA",
"postal_code": "315486507",
"telephone_number": "912-729-2821",
"fax_number": "912-729-2823"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1481 HWY 40 E",
"city": "KINGSLAND",
"state": "GA",
"postal_code": "315486507",
"telephone_number": "912-729-2821",
"fax_number": "912-729-2823"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMELIA MEDICAL SERVICES, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "AMELIA MEDICAL SERVICES, LLC",
"enumeration_date": "2010-08-27",
"last_updated": "2023-03-07",
"status": "A",
"authorized_official_last_name": "MATRICIA",
"authorized_official_first_name": "DANIEL",
"authorized_official_middle_name": "J.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "912-729-2821",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "GA",
"license": "031289",
"primary": true
},
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GA MEDICAL LICENSE",
"identifier": "031289",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI - MATRICIA",
"identifier": "1912972530",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Amelia Medical Care, Kingsland",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Kingsland, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.