Nicole Thomas, ATC, LAT

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

AT002470 Issued in GA

Practice address

13025 Birmingham Hwy
Milton, GA 30004-7306

Phone

(470) 254-7000

NPI assigned

Oct 7, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1205477635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1248 AUTUMN WOOD TRL",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305188627",
            "telephone_number": "770-845-0385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13025 BIRMINGHAM HWY",
            "city": "MILTON",
            "state": "GA",
            "postal_code": "300047306",
            "telephone_number": "470-254-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "NICOLE",
        "credential": "ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "GA",
            "license": "AT002470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicole.thomas@sourceatlanta.com",
            "affiliation": "N",
            "address_1": "13025 Birmingham Hwy",
            "city": "Milton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300047306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Milton, GA
• Providers in Milton, GA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.