Individual provider Active NPI

Thomas S Kraemer, PA

  • Physician Assistant
  • Tifton, GA
National Provider Identifier
1275562266
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
00377 Issued in GA
Practice address
901 18TH St E
Tifton, GA 31794-3648
Phone
(229) 382-7120
Fax
(229) 388-5685
NPI assigned
Jul 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 00377 GA Primary

Addresses

Primary practice location

901 18TH St E
Tifton, GA 31794-3648

Mailing address

907 18TH St E Ste 400
Tifton, GA 31794-3684
Phone (229) 388-5690

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address thomas.kraemer@trhs.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
377GAMDAcupuncturist
00377GAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1275562266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 18TH ST E STE 400",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943684",
            "telephone_number": "229-388-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 18TH ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943648",
            "telephone_number": "229-382-7120",
            "fax_number": "229-388-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAEMER",
        "first_name": "THOMAS",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-02",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "00377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomas.kraemer@trhs.cernerdirect.com",
            "affiliation": "N",
            "address_1": "901 18th St E",
            "city": "Tifton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "317943648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

Verify at the official NPI Registry.