Organization Active NPI

Direct Patient Care of Thomasville LLC

  • Internal Medicine Physician
  • Thomasville, GA
National Provider Identifier
1356955645
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DIRECT PATIENT CARE OF THOMASVILLE LLC
Practice address
701 S Hansell St
Thomasville, GA 31792-5558
Phone
(229) 233-6326
NPI assigned
Sep 3, 2020
Last updated
Oct 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Authorized official

Name
Dr. Martha Susan Ward, MDNPI 1871609248
Title
Sole Member
Phone
(229) 233-6326

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

701 S Hansell St
Thomasville, GA 31792-5558

Mailing address

701 S Hansell St
Thomasville, GA 31792-5558
Phone (229) 233-6326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201216000274 GA Part B Supplier - Clinic/Group Practice 2567874548 Receives reassigned benefits from 1 practitioner
Practice locations: Thomasville, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2217927Direct Patient Care of Thomasville701 South Hansell Street, Thomasville, GA 31792Certificate of waiverMar 23, 2027

National Provider Directory

National Provider Directory

Locations

701 S Hansell St
Thomasville, GA 31792
Phone (229) 226-9355

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602633600000",
    "number": "1356955645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S HANSELL ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925558",
            "telephone_number": "229-233-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S HANSELL ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925558",
            "telephone_number": "229-233-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECT PATIENT CARE OF THOMASVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "229-233-6326",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.