Individual provider Active NPI

Nadine American Thomas, M.D.

  • Pediatric Adolescent Medicine Physician
  • East Ellijay, GA
National Provider Identifier
1265532808
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
63743 Issued in GA
Practice address
772 Maddox Dr Ste 122
East Ellijay, GA 30540-8196
Phone
(706) 635-6898
Fax
(706) 635-6885
NPI assigned
Sep 24, 2006
Last updated
Dec 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 63743 GA Primary

Addresses

Primary practice location

772 Maddox Dr Ste 122
East Ellijay, GA 30540-8196

Mailing address

165 Blue Ridge Overlook
Blue Ridge, GA 30513-4431
Phone (706) 946-5602

Other names 1

  • Dr. Nadine Karlena American Professional name

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
I20120918000598 GA Practitioner - Pediatric Medicine 3173771037

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63743GAMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Health Corp of Ellijay Current Accepting new patients

Locations

1362 S Main St
Ellijay, GA 30540
Phone (706) 276-2417

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1265532808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 BLUE RIDGE OVERLOOK",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305134431",
            "telephone_number": "706-946-5602",
            "fax_number": "706-374-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "772 MADDOX DR STE 122",
            "city": "EAST ELLIJAY",
            "state": "GA",
            "postal_code": "305408196",
            "telephone_number": "706-635-6898",
            "fax_number": "706-635-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "NADINE",
        "middle_name": "AMERICAN",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "GA",
            "license": "63743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NADINE",
            "last_name": "AMERICAN",
            "middle_name": "KARLENA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in East Ellijay, GA

Sources for this page

Verify at the official NPI Registry.