NPIMap

Organization Active NPI

Thomas W. Bantly, M.D., P.C

  • Psychiatry Physician
  • Snellville, GA
National Provider Identifier
1356594709
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
THOMAS W. BANTLY, M.D., P.C
Practice address
1700 Tree Lane Road
Suite 260
Snellville, GA 30078-6782
Phone
(770) 736-7534
Fax
(770) 736-8627
NPI assigned
Oct 29, 2008
Last updated
Oct 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

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

Authorized official

Name
Dr. Thomas W. Bantly, M.D.NPI 1003901422
Title
President/Ceo
Phone
(770) 738-7534

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

1700 Tree Lane Road
Suite 260
Snellville, GA 30078-6782

Mailing address

1700 Tree Lane Road
Suite 260
Snellville, GA 30078-6782
Phone (770) 736-7534

National Provider Directory

National Provider Directory

Locations

1700 Tree Ln
Ste 260
Snellville, GA 30078
Phone (770) 736-7534

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225238400000",
    "number": "1356594709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 TREE LANE ROAD",
            "address_2": "SUITE 260",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786782",
            "telephone_number": "770-736-7534",
            "fax_number": "770-736-8627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 TREE LANE ROAD",
            "address_2": "SUITE 260",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786782",
            "telephone_number": "770-736-7534",
            "fax_number": "770-736-8627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS W. BANTLY, M.D., P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-29",
        "last_updated": "2008-10-29",
        "status": "A",
        "authorized_official_last_name": "BANTLY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "770-738-7534",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; 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.