Individual provider Active NPI

Dexter Terrence Todmann, M.D.

  • General Practice Physician
  • Chamblee, GA
National Provider Identifier
1063700672
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22067 Issued in GA
Practice address
5134 Peachtree Rd
Chamblee, GA 30341-2724
Phone
(678) 872-7100
NPI assigned
Jul 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 22067 GA Primary

Addresses

Primary practice location

5134 Peachtree Rd
Chamblee, GA 30341-2724

Mailing address

2200 Century Pkwy NE
Suite 600
Atlanta, GA 30345-3154
Phone (404) 633-4838

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
I20120306000717 GA Practitioner - Internal MedicinePractitioner - Geriatric Medicine 0840459160 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph'S Mercy Care Services Inc Current Accepting new patients
Saint Joseph'S Mercy Care Services, Inc. CurrentSince Apr 9, 2023 Accepting new patients
Saint Joseph'S Mercy Care Services Inc CurrentSince Apr 9, 2023 Accepting new patients

Locations

424 Decatur St SE
Atlanta, GA 30312
Phone (678) 843-8500

5134 Peachtree Rd
Chamblee, GA 30341
Phone (678) 872-7100

Interoperability endpoints

  • Direct secure messaging: dtodmann617332@direct.ochin.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1310860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1063700672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 CENTURY PKWY NE",
            "address_2": "SUITE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303453154",
            "telephone_number": "404-633-4838",
            "fax_number": "404-296-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5134 PEACHTREE RD",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303412724",
            "telephone_number": "678-872-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODMANN",
        "first_name": "DEXTER",
        "middle_name": "TERRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-17",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "22067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chamblee, GA

Sources for this page

Verify at the official NPI Registry.