KINGS BAY FAMILY CARE
NPI 1477698611
Family Medicine in Saint Marys, GA
NPI Status: Active since February 21, 2007
Contact Information
340 CHARLIE SMITH SR HWY
SAINT MARYS, GA
ZIP 31558
Phone: (912) 882-5030
Fax: (888) 476-5235
- Organization
- Family Medicine
- CLIA Number: 11D2313562
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 11-03-2026
About KINGS BAY FAMILY CARE
This page provides the complete NPI Profile along with additional information for Kings Bay Family Care, a primary care provider established in Saint Marys, Georgia operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1477698611 assigned on February 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 052769 (GA). The provider is registered as an organization and their NPI record was last updated 13 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Kings Bay Family Care. The authorized official of this NPI record is Dr. Angelito Buencamino Lacanilao M.d. (President)
- NPI
- 1477698611
- Provider Legal Name
- LACANILAO MEDICAL MANAGEMENT PC
- Other Organization Name
- KINGS BAY FAMILY CARE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 340 CHARLIE SMITH SR HWY SAINT MARYS, GA 31558
- Location Phone
- (912) 882-5030
- Location Fax
- (888) 476-5235
- Mailing Address
- 340 CHARLIE SMITH SR HWY SAINT MARYS, GA 31558
- Mailing Phone
- (912) 882-5030
- Mailing Fax
- (888) 476-5235
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-21-2007
- Last Update Date
- 12-20-2012
- Code Navigator
A primary care provider (PCP) like Kings Bay Family Care sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 052769
- License State
- GA
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1477698611 | OTHER (01) | GA | NPI |
| H84791 | MEDICARE UPIN (02) | GA | |
| 083558714B | MEDICAID (05) | GA | |
| GRP6277 | OTHER (01) | GA | MEDICARE PTAN |
| 08BBQQD | MEDICARE ID-TYPE UNSPECIFIED (04) | GA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2313562
- Facility Type
- Physician Office
- Certificate Effective Date
- November 04, 2024
- Certificate Expiration Date
- November 03, 2026
- Laboratory Director
- ANGELITO LACANILAO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Kings Bay Family Care to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 7 | 7 | 6 | 9 | 8 | 6 | 1 | 1 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 14 | 7 | 12 | 9 | 16 | 6 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 4 + 7 + 1 + 2 + 9 + 1 + 6 + 6 + 2 + 24 = 69 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 69 = 1 | 1 | ||||||||
The NPI number 1477698611 is valid because the calculated check digit 1 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1477698611, enumerated in the NPI registry as an "organization" on February 21, 2007
The provider is located at 340 Charlie Smith Sr Hwy Saint Marys, Ga 31558 and the phone number is (912) 882-5030
This medical organization specializes in Family Medicine with taxonomy code 207Q00000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 11D2313562 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on February 21, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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