Thomas W Bantly, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

023013 Issued in GA

Practice address

1700 Tree Lane Road Sutie 260
Snellville, GA 30078

Phone

(770) 736-7534

Fax

(770) 736-8627

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Judy M Plecko and Associates, L.L. C

  • Clinical Social Worker
  • Snellville, GA
  • NPI 1962679209
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003901422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 TREE LANE ROAD SUTIE 260",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "30078",
            "telephone_number": "770-736-7534",
            "fax_number": "770-736-8627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 TREE LANE ROAD SUTIE 260",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "30078",
            "telephone_number": "770-736-7534",
            "fax_number": "770-736-8627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANTLY",
        "first_name": "THOMAS",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "023013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall Noel Ballard
• Glenn Banegura, M.D.
• Aminat Banjo, NP
• Oluwadamilola Bankole, APRN
• Savon Banks, RBT
• Farzana Barati
• Xzavion William Bard
• Bardi Homecare
• Alisa Nicole Barker, PHARMD
• Ethelyn Barksdale

• Psychiatry Physician in Snellville, GA
• Providers in Snellville, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.