Individual provider Active NPI

Casey Tomlinson

  • Professional Counselor
  • Statesboro, GA
National Provider Identifier
1366274466
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
APC009777 Issued in GA
Practice address
326 Myrtle Crossing Dr Ste 200
Statesboro, GA 30458-4689
Phone
(912) 489-7590
NPI assigned
Aug 16, 2024
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X APC009777 GA Primary

Addresses

Primary practice location

326 Myrtle Crossing Dr Ste 200
Statesboro, GA 30458-4689

Mailing address

411 Hartley Dr
Statesboro, GA 30458-9403
Phone (702) 306-6990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APC009777GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fresh Start Counseling Services Professional PastSince Aug 18, 2024 Accepting new patients

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": "1723766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1366274466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 HARTLEY DR",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304589403",
            "telephone_number": "702-306-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 MYRTLE CROSSING DR STE 200",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584689",
            "telephone_number": "912-489-7590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMLINSON",
        "first_name": "CASEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC009777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.