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

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

Organization subpart

No

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.

Title

President/Ceo

Phone

(770) 738-7534

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Samuel Eddinger, DMIN

  • Marriage & Family Therapist
  • Snellville, GA
  • NPI 1851495949
  NPD (past)
• Joyce Muller Moore, LPC

  • Professional Counselor
  • Snellville, GA
  • NPI 1427325851
  NPD (past)
• Lois Muir-McClain, M.A., LPC

  • Professional Counselor
  • Snellville, GA
  • NPI 1780747246
  NPD (past)
• Judith Martin Plecko, L.C.S.W

  • Clinical Social Worker
  • Snellville, GA
  • NPI 1538241138
  NPD (past)

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000275877B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Women'S Group of Gwinnett, P.C.
• Therapeutic Resolutions LLC
• Jennifer Jeri Thigpen Hearn, CRNA
• Kenneth Allen Thisdale, M.A., CCC-SLP
• Stephanie Thom, LAPC
• Abel Thomas, CPHT
• Cherrell D Thomas, LPC, NCC
• Keldreca Shuntae Thomas, FNP
• Makyla Elise Thomas
• Mark Shannon Thomas

• Psychiatry Physician in Snellville, GA
• Providers in Snellville, GA by specialty
• Psychiatry Physician in Georgia

• 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.