NPIMap

Individual provider Active NPI

Thomas D Fausett Jr., MD

  • Family Medicine Physician
  • Adel, GA
National Provider Identifier
1366513210
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
046090 Issued in GA
Practice address
707 N Parrish Ave
Adel, GA 31620
Phone
(229) 896-7007
Fax
(229) 896-7627
NPI assigned
Nov 13, 2006
Last updated
Jan 20, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 046090 GA Primary

Addresses

Primary practice location

707 N Parrish Ave
Adel, GA 31620

Mailing address

707 N Parrish Ave
Adel, GA 31620
Phone (229) 896-7007

Other identifiers 1

IdentifierTypeStateIssuer
00801754FMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051206000824 GA Practitioner - Family Practice 6507886421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mercer University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas D Fausett Jr MD PCGroup PAC ID 8224202601, 2 clinicians

Practice addresses (Care Compare)

707 N Parrish Ave
Adel, GA 31620-1521
Phone (229) 896-7007

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tia S Sanderlin MD PC Family Medicine CurrentSince Apr 1, 2003 Accepting new patients
Tift Regional Health System Inc CurrentSince Apr 24, 2015 Accepting new patients
Adel Emergency Physicians, LLC Past Accepting new patients
Tift Regional Health System Inc Past Accepting new patients
Healthcare of Berrien County, Inc. Past Accepting new patients

Locations

172 Mj Taylor Rd
Adel, GA 31620
Phone (229) 896-3424

308 N Parrish Ave
Adel, GA 31620
Phone (229) 247-2290

706 N Parrish Ave
Adel, GA 31620
Phone (229) 896-8000

707 N Parrish Ave
Adel, GA 31620
Phone (229) 896-7007

1221 E McPherson Ave
Nashville, GA 31639
Phone (229) 543-7100

1622 Madison Ave
Tifton, GA 31794
Phone (229) 387-8061

2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Southwell Health and RehabilitationAdel, GA, CCN 115655 Skilled nursing facility Corporate Officer
Adp of the SNF
Direct Ownership Interest		 Mar 1, 2019
Mar 1, 2019
Mar 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1366513210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 N PARRISH AVE",
            "city": "ADEL",
            "state": "GA",
            "postal_code": "31620",
            "telephone_number": "229-896-7007",
            "fax_number": "229-896-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N PARRISH AVE",
            "city": "ADEL",
            "state": "GA",
            "postal_code": "31620",
            "telephone_number": "229-896-7007",
            "fax_number": "229-896-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUSETT",
        "first_name": "THOMAS",
        "middle_name": "D",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "046090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00801754F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Adel, GA

Sources for this page

Verify at the official NPI Registry.