Individual provider Active NPI

Jasmine Mutti, MD

  • Infectious Disease Physician
  • Thomasville, GA
National Provider Identifier
1063074045
Registry record updated Dec 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
100435 Issued in GA
Practice address
100 Mimosa Dr Ste 1L
Thomasville, GA 31792-6678
Phone
(229) 228-2410
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57.248009 OH
Infectious Disease Physician 207RI0200X 100435 GA Primary

Addresses

Primary practice location

100 Mimosa Dr Ste 1L
Thomasville, GA 31792-6678

Mailing address

100 Mimosa Dr Ste 1L
Thomasville, GA 31792-6678

Other practice location 1

18101 Lorain Ave
Cleveland, OH 44111-5612
Phone (216) 476-7000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241014000628 GA Practitioner - Infectious DiseasePractitioner - Internal Medicine 4385079771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Archbold Medical Group, Inc.Group PAC ID 8123196383, 80 clinicians

Practice addresses (Care Compare)

100 Mimosa Dr
Suite 1L
Thomasville, GA 31792-6678
Phone (229) 228-2410

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
100435GAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Archbold Medical Group, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Archbold Medical Group, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

900 Cairo Rd
Thomasville, GA 31792
Phone (229) 227-5102

100 Mimosa Dr
Ste 1L
Thomasville, GA 31792
Phone (229) 228-2410

100 Mimosa Dr
Thomasville, GA 31792
Phone (229) 226-9141

100 Mimosa Dr
Ste 1M
Thomasville, GA 31792
Phone (229) 584-5640

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735344000000",
    "number": "1063074045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MIMOSA DR STE 1L",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MIMOSA DR STE 1L",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926678",
            "telephone_number": "229-228-2410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18101 Lorain Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441115612",
            "country_code": "US",
            "telephone_number": "216-476-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUTTI",
        "first_name": "JASMINE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.248009",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "GA",
            "license": "100435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.