Individual provider Active NPI

Tommie Joann Floyd, A.P.N.

  • Family Nurse Practitioner
  • Douglasville, GA
National Provider Identifier
1013396878
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN123475 Issued in GA
Practice address
6025 Professional Pkwy Ste 200
Douglasville, GA 30134-5610
Phone
(770) 949-0555
NPI assigned
May 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN123475 GA Primary

Addresses

Primary practice location

6025 Professional Pkwy Ste 200
Douglasville, GA 30134-5610

Mailing address

845 Scenic Hwy
#100
Lawrenceville, GA 30046-7103
Phone (770) 962-6443

Other practice location 1

845 Scenic Hwy
#100
Lawrenceville, GA 30046-7103
Phone (770) 962-6443

Other names 1

  • Tommie Joann Floyd Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151023002486 GA Practitioner - Nurse Practitioner 5193034619 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN123475GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Bortolazzo Group, LLC CurrentSince Jan 1, 2019 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1013396878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 SCENIC HWY",
            "address_2": "#100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467103",
            "telephone_number": "770-962-6443",
            "fax_number": "770-964-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 PROFESSIONAL PKWY STE 200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345610",
            "telephone_number": "770-949-0555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "845 Scenic Hwy",
            "address_2": "#100",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300467103",
            "country_code": "US",
            "telephone_number": "770-962-6443",
            "fax_number": "770-964-8355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLOYD",
        "first_name": "TOMMIE",
        "middle_name": "JOANN",
        "name_prefix": "Ms.",
        "credential": "A.P.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-27",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN123475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOMMIE",
            "last_name": "FLOYD",
            "middle_name": "JOANN",
            "credential": "MSN, APRN,FNP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.