Individual provider Active NPI

Edward T Wright III, M.D.

  • Anatomic Pathology Physician
  • Thomasville, GA
National Provider Identifier
1124081393
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
051862 Issued in GA
Practice address
130 N Broad St
Thomasville, GA 31792-8132
Phone
(229) 228-6496
Fax
(229) 228-6510
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 051862 GA Primary

Addresses

Primary practice location

130 N Broad St
Thomasville, GA 31792-8132

Mailing address

130 N Broad St
Thomasville, GA 31792-8132
Phone (229) 228-6496

Other identifiers 1

IdentifierTypeStateIssuer
0049876BMedicaidGA

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
I20101117001114 GA Practitioner - Pathology 7911192893 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Medical College of Georgia School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathology Associates, P.C.Group PAC ID 0143214460, 4 clinicians
Pineview PathologyGroup PAC ID 6800268038, 4 clinicians

Practice addresses (Care Compare)

130 N Broad St
Thomasville, GA 31792-8132
Phone (229) 228-6496

2501 N Patterson St
Valdosta, GA 31602-1735
Phone (229) 421-6659

915 Gordon Ave
Thomasville, GA 31792-6614
Phone (229) 228-6496

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
051862GAMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology Associates, P.C. Anatomic Pathology CurrentSince Aug 1, 2002 Accepting new patients
Pineview Pathology CurrentSince Nov 1, 2022 Accepting new patients
Physician Laboratory Consultants LLC Past Accepting new patients

Locations

130 N Broad St
Thomasville, GA 31792
Phone (229) 228-6496

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

5700 Southwyck Blvd
Toledo, OH 43614

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.

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1124081393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N BROAD ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317928132",
            "telephone_number": "229-228-6496",
            "fax_number": "229-228-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N BROAD ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317928132",
            "telephone_number": "229-228-6496",
            "fax_number": "229-228-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "EDWARD",
        "middle_name": "T",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "GA",
            "license": "051862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0049876B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.