# SOUTHERN SHORES FAMILY CARE LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972479541
- **Authorized official:** KRISTINA JOHNSON MD (OWNER)
- **Authorized official phone:** (912) 550-3094

## Contact information

- **Practice address:** 2658 US HIGHWAY 17, RICHMOND HILL, GA 31324-3374
- **Practice address phone:** (912) 356-9900
- **Practice address fax:** (912) 550-3094
- **Mailing address:** 2658 US HIGHWAY 17, RICHMOND HILL, GA 31324-3374
- **Mailing address phone:** (912) 356-9900
- **Mailing address fax:** (912) 445-6012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/13/2025
- **Last updated:** 04/10/2026