Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bolivia Traci Jenkins, MD

Individual provider Family Medicine Physician · NPI 1275111304

Bolivia Traci Jenkins, MD is a Family Practice in Gray, Georgia. Qualified in 2020, 6 years ago. Practices with Southern Regional Physicians Management Group, LLC, a 28-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
6
Licensed in
GA
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1005 Boulder Dr
Gray, GA 31032-6141
Phone: (478) 621-2072
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 99763 (GA)

Record details

NPI number1275111304
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 30, 2021
Last updated in NPPESAugust 15, 2024
Certification dateAugust 15, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Southern Regional Physicians Management Group, Llc — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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