NPI age
5 years
Enumerated 2020-07-09
● Active Type 2 · Organization
Statesboro Medical Group, Llc
Statesboro Medical Group, Llc is 1 of 354 clinic/center organizations in Georgia.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Dega
Owner
Last NPPES update
2020-09-11
Source: monthly bulk 2026-05
How this organization compares
Across 354 active clinic/center providers in Georgia.
NPI age
5 years
↓ 5 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2020 → 2026
2020-07Enumerated in NPPES
2020
2026
Where they practice
Primary practice location
1176 Brampton Ave
Statesboro, GA 304580847
Mailing address
106 Irongate Pl
Statesboro, GA 304589173
Authorized official
Sreevalli Dega, MD
Owner
📞 9122599474
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Scott Fouch, PA-C Physician Assistant NPI 1407828338
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 1023247723 | NPI |
| 01 (GA) | 1023247731 | NPI |
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Statesboro urgent care
-
Statesboro urgent care
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.