Southeast Ga Primary Prevent
NPI 1649470410 · Family Medicine Physician · Vidalia, GA
Southeast Ga Primary Prevent is a Family Medicine Physician organization in Vidalia, GA (NPI 1649470410).
Provider details
- NPI number
- 1649470410
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lisa Bush, Billing Manager(912) 537-9779
- License
- 052930 (GA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-07-20
- Last updated
- 2008-05-08
Frequently asked questions
- What is Southeast Ga Primary Prevent's NPI number?
- Southeast Ga Primary Prevent's National Provider Identifier (NPI) is 1649470410, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southeast Ga Primary Prevent?
- Southeast Ga Primary Prevent is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Southeast Ga Primary Prevent located?
- Southeast Ga Primary Prevent's practice location on file with NPPES is 1811 Edwina Dr, Vidalia, GA 30474-8963.
- What is Southeast Ga Primary Prevent's phone number?
- The practice phone number listed in the NPPES registry for Southeast Ga Primary Prevent is (912) 537-9779.
- Who is the authorized official for Southeast Ga Primary Prevent?
- The authorized official listed on Southeast Ga Primary Prevent's NPPES record is Lisa Bush, Billing Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southeast Ga Primary Prevent's NPI active?
- Yes — Southeast Ga Primary Prevent's NPI (1649470410) is active in the NPPES registry as of the last update on 2008-05-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.