Individual provider Active NPI

Thomas Earle Sholes, MD

  • Gynecology Physician
  • Gainesville, GA
National Provider Identifier
1215907365
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
025275 Issued in GA
Practice address
725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834
Phone
(770) 297-2200
Fax
(770) 534-8139
NPI assigned
Jan 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 025275 GA Primary

Addresses

Primary practice location

725 Jesse Jewell Pkwy SE
Gainesville, GA 30501-3834

Mailing address

PO Box 658
Gainesville, GA 30503-0658
Phone (770) 718-1122

Other identifiers 11

IdentifierTypeStateIssuer
0700333OtherGAUNITED HEALTHCARE
4107957OtherGAAETNA
4253128OtherGACIGNA
338806OtherGAWELLCARE
52238013OtherGABCBS
000326356HMedicaidGA
00326356IMedicaidGA
000326356BMedicaidGA
000326356GMedicaidGA
10045082OtherGAAMERIGROUP
160029734OtherGARR MEDICARE-GRP # CC4177

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

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1215907365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 658",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305030658",
            "telephone_number": "770-718-1122",
            "fax_number": "770-535-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013834",
            "telephone_number": "770-297-2200",
            "fax_number": "770-534-8139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOLES",
        "first_name": "THOMAS",
        "middle_name": "EARLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "GA",
            "license": "025275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0700333",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4107957",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4253128",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "338806",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52238013",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000326356H",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00326356I",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000326356B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000326356G",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10045082",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE-GRP # CC4177",
            "identifier": "160029734",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; 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.