Maritess Gonzales Thomas, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN161969 Issued in GA

Practice address

3800 Princeton Lakes Pkwy SW
Atlanta, GA 30331-5580

Phone

(404) 948-3019

NPI assigned

Aug 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Maritess Gonzales Thomas-Ford Other name

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Southside Internal Medicine PCGroup PAC ID 5092904144, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IDFFAA/Endpoint/IDFFAA

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.

• Piedmont Professional Services, LLC

  • Nephrology Physician
  • Stockbridge, GA
  • NPI 1104088905
  Medicare reassignment Care Compare group NPD
• Southside Internal Medicine PC

  • Primary Care Clinic/Center
  • Riverdale, GA
  • NPI 1740583194
  Medicare reassignment Care Compare group
• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Ellenwood, GA
  • NPI 1447290218
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Locust Grove, GA
  • NPI 1710929914
  NPD (past)
• Aylo Health, LLC

  • Sleep Medicine (Family Medicine) Physician
  • Stockbridge, GA
  • NPI 1922831445
  NPD (past)
• Piedmont Medical Care Corporation

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1912956046
  NPD (past)

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1013461425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1058 BEAR CREEK BLVD",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302281849",
            "telephone_number": "770-707-0808",
            "fax_number": "770-707-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 PRINCETON LAKES PKWY SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315580",
            "telephone_number": "404-948-3019"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1058 Bear Creek Blvd",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "GA",
            "postal_code": "302281849",
            "country_code": "US",
            "telephone_number": "770-707-0808",
            "fax_number": "770-707-1580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MARITESS",
        "middle_name": "GONZALES",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN161969",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN161969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARITESS",
            "last_name": "THOMAS-FORD",
            "middle_name": "GONZALES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Koekland Thomas
• Lauree Emelia Thomas, CAA
• Laurel Adeline Thomas
• Lauren Thomas
• Marianna Thomas
• Megan F Thomas, DC
• Melanie Morgan Thomas
• Michael Robert Thomas, D.C
• Mikalah Unique Thomas
• Miriam Thomas, M.D.

• Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.