EXCLUDEDPROVIDER
Entity Nondisclosure

Crest Medical Of Wauchula

Decatur, GA 30030

Public HHS-OIG LEIE exclusion record

According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Crest Medical Of Wauchula of Decatur, GA is currently excluded from participation in federally funded health care programs due to failure to disclose required information, as of December 20, 1993.

Status
Currently listed by HHS-OIG
Record type
Entity
Location
Decatur, GA 30030
Exclusion date
December 20, 1993
Exclusion type
Nondisclosure (1128b11)
Source dataset
May 2026

Record summary

Crest Medical Of Wauchula appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an entity record associated with Decatur, Georgia. The latest imported LEIE dataset lists this record as currently excluded from participation in federally funded health care programs. The exclusion date shown in the source record is December 20, 1993, and the exclusion type is 1128b11, identified by HHS-OIG as failure to disclose required information.

Source record

SourceHHS-OIG LEIE (public dataset)
Record typeEntity
Current statusCurrently listed by HHS-OIG
Exclusion dateDecember 20, 1993
Exclusion typeFailure to disclose required information (1128b11)
Source dataset dateMay 2026

What this exclusion type means

HHS-OIG identifies exclusion type 1128b11 as “Failure to disclose required information.” Failure to disclose required information, to supply requested information on subcontractors and suppliers, or to supply payment information (permissive exclusion).

This exclusion type is a statutory category used by HHS-OIG in the LEIE dataset. The category describes the legal authority associated with the exclusion record, not a separate investigation or additional reporting by Excluded Provider.

Location and provider classification

This LEIE record is associated with Decatur, GA 30030. The listed provider category is Government Contractor.

Other excluded providers in Decatur, GA

Other individuals and entities currently listed in the HHS-OIG LEIE public dataset with a Decatur, GA address.

Valerie La Shan West Individual Patient Abuse
Decatur, GA · Conviction relating to patient abuse or neglect · Excluded Nov 2024
Glenn Pair Individual Program Crime
Decatur, GA · Conviction of program-related crimes · Excluded Jan 2023
Wax David Barnell Flowers Individual Program Crime
Decatur, GA · Conviction of program-related crimes · Excluded Aug 2020
Kim Bray Individual Program Crime
Decatur, GA · Conviction of program-related crimes · Excluded Mar 2019
Patrice Rose Copenny Individual Program Crime
Decatur, GA · Conviction of program-related crimes · Excluded Jun 2018
Andre Damian Sr Williams Individual Program Crime
Decatur, GA · Conviction of program-related crimes · Excluded Feb 2015
Allen Troy Flynt Individual Program Crime
Decatur, GA · Conviction of program-related crimes · Excluded Feb 2015
George Boyd Individual Program Crime
Decatur, GA · Conviction of program-related crimes · Excluded Jul 2012

See all 69 excluded providers in Decatur →

How to verify this record

This page is a public-record summary and should be treated as a possible LEIE match, not final identity verification. To verify the record, use the official HHS-OIG LEIE search and compare available identifying information through the official process. Name, location, provider category, specialty, exclusion date, and NPI should be treated as matching clues rather than final proof of identity.

What this page does not include

This page summarizes the HHS-OIG LEIE public dataset only. It does not search state Medicaid exclusion lists, state licensing-board actions, court records, malpractice records, employment history, civil lawsuits, or non-public investigations.

Verify with HHS-OIG Remove / correct this record

Related

More Excluded Entities in Georgia More Records in Decatur More Nondisclosure Records