Individual provider Active NPI

Phoebe Gates Thorpe, M.D., M.P.H.

  • Specialist
  • Stone Mountain, GA
National Provider Identifier
1003814369
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
53889 Issued in GA
Practice address
5405 Memorial Dr
Suite D
Stone Mountain, GA 30083-3234
Phone
(404) 296-3800
Fax
(404) 297-8753
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 53889 GA Primary

Addresses

Primary practice location

5405 Memorial Dr
Suite D
Stone Mountain, GA 30083-3234

Mailing address

5405 Memorial Dr Ste D
Stone Mountain, GA 30083-3236
Phone (404) 296-3800

Other identifiers 1

IdentifierTypeStateIssuer
175583131AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
53889GAMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1003814369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 MEMORIAL DR STE D",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833236",
            "telephone_number": "404-296-3800",
            "fax_number": "404-297-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 MEMORIAL DR",
            "address_2": "SUITE D",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833234",
            "telephone_number": "404-296-3800",
            "fax_number": "404-297-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORPE",
        "first_name": "PHOEBE",
        "middle_name": "GATES",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "53889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175583131A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.