Active NPI
William Thomas Mac New Jr., MD
- Family Medicine Physician
- Winder, GA
National Provider Identifier
1104851930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 21755
- Practice address
- 314 N Broad St
Suite 250
Winder, GA 30680-2191 - Phone
- (770) 867-4146
- Fax
- (770) 867-3742
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 21755 | GA | Primary |
Addresses
Primary practice location
314 N Broad St
Suite 250
Winder, GA 30680-2191
Mailing address
314 N Broad St
Suite 250
Winder, GA 30680-2191
Phone (770) 867-4146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000253756A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21755 | GA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William T. Mac New, Jr. MD, PC | Family Medicine | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Winder, GA
- NPI 1477864320
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388707200000",
"number": "1104851930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "314 N BROAD ST",
"address_2": "SUITE 250",
"city": "WINDER",
"state": "GA",
"postal_code": "306802191",
"telephone_number": "770-867-4146",
"fax_number": "770-867-3742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "314 N BROAD ST",
"address_2": "SUITE 250",
"city": "WINDER",
"state": "GA",
"postal_code": "306802191",
"telephone_number": "770-867-4146",
"fax_number": "770-867-3742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAC NEW",
"first_name": "WILLIAM",
"middle_name": "THOMAS",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2014-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "21755",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000253756A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winder, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.