Individual provider Active NPI

Timothy Nathan Thomas, D.O.

  • Emergency Medicine Physician
  • Columbus, OH
National Provider Identifier
1255546487
Registry record updated May 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
58002235 Issued in OH
Practice address
5100 W Broad St
Columbus, OH 43228-1607
Phone
(614) 544-1000
NPI assigned
May 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 58002235 OH Primary

Addresses

Primary practice location

5100 W Broad St
Columbus, OH 43228-1607

Mailing address

119 Fairway Dr
Carrollton, GA 30117-4134
Phone (614) 877-4153

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
I20160711001015 GA Practitioner - Emergency Medicine 3274694146 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carrollton Emergency Physicians PCGroup PAC ID 7416860010, 34 clinicians

Practice addresses (Care Compare)

705 Dixie St
Carrollton, GA 30117-3818
Phone (770) 812-9666

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
58002235OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carrollton Emergency Physicians, PC Emergency Medicine CurrentSince Jun 1, 2016 Accepting new patients
Fairfield Emergency Physicians Inc Emergency Medicine Past Accepting new patients
Fairfield ER Physicians Dba Fairfield Medical Center Pro Fee Emergency Medicine Past Accepting new patients

Locations

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

601 Dallas Hwy
Villa Rica, GA 30180
Phone (770) 456-3000

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494979200000",
    "number": "1255546487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 FAIRWAY DR",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174134",
            "telephone_number": "614-877-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281607",
            "telephone_number": "614-544-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "TIMOTHY",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-11",
        "last_updated": "2017-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "58002235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.