Individual provider Active NPI

Thomas John Demarco, MD

  • Gastroenterology Physician
  • Smyrna, GA
National Provider Identifier
1093825846
Registry record updated Apr 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
32718 Issued in GA
Practice address
3969 S Cobb Dr SE Ste 202
Smyrna, GA 30080-6317
Phone
(770) 432-5326
Fax
(770) 432-5740
NPI assigned
Aug 30, 2006
Last updated
Apr 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 32718 GA Primary

Addresses

Primary practice location

3969 S Cobb Dr SE Ste 202
Smyrna, GA 30080-6317

Mailing address

3969 S Cobb Dr SE Ste 202
Smyrna, GA 30080-6317
Phone (770) 432-5326

Other identifiers 1

IdentifierTypeStateIssuer
00422518AMedicaidGA

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
I20110223000959 GA Practitioner - Internal Medicine 3971555129 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32718GAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cobb Endoscopy Center LLC CurrentSince Nov 26, 2001 Accepting new patients
Homestead Hospice of Cartersville, LLC CurrentSince Aug 25, 2022 Accepting new patients
Thomas J. Demarco Gastroenterology CurrentSince Apr 1, 1990 Accepting new patients

Locations

100 Market Place Blvd
Ste 301
Cartersville, GA 30121
Phone (678) 290-4817

3903 S Cobb Dr SE
Ste 200
Smyrna, GA 30080
Phone (770) 435-3214

3969 S Cobb Dr SE
Ste 202
Smyrna, GA 30080
Phone (770) 432-5326

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Amity Care HospiceMarietta, GA, CCN 111692 Hospice Contracted Managing Employee (50%) Apr 10, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1093825846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3969 S COBB DR SE STE 202",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806317",
            "telephone_number": "770-432-5326",
            "fax_number": "770-432-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3969 S COBB DR SE STE 202",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806317",
            "telephone_number": "770-432-5326",
            "fax_number": "770-432-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMARCO",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "32718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00422518A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.