Timothy R Thaller, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

046818 Issued in GA

Practice address

1497 Fair Rd Ste 102
Statesboro, GA 30458-0823

Phone

(912) 764-9001

Fax

(912) 764-3166

NPI assigned

Aug 23, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Urology

Education

Louisiana State University School of Medicine in Shreveport, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Georgia Hma Physician Management LLCGroup PAC ID 7214068592, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075
• Evans Memorial Hospital Hospital, Claxton, GA, CCN 110142
• Emanuel Medical Center Hospital, Swainsboro, GA, CCN 110109
• Memorial Health Meadows Hospital Hospital, Vidalia, GA, CCN 110128
• Effingham Health System Hospital, Springfield, GA, CCN 111306

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothy.thaller.1@8824.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• East Georgia Hma Physician Management, LLC

  • Internal Medicine Physician
  • Statesboro, GA
  • NPI 1487983151
  Medicare reassignment Care Compare group NPD

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

• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  Care Compare affiliation
• Effingham Hospital, Inc.

  • Critical Access Hospital
  • Springfield, GA
  • NPI 1811962756
  Care Compare affiliation
• Emanuel County Hospital Authority

  • Rural Acute Care Hospital
  • Swainsboro, GA
  • NPI 1235129214
  Care Compare affiliation
• Evans Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Claxton, GA
  • NPI 1730110826
  Care Compare affiliation
• Vidalia Health Services, LLC

  • General Acute Care Hospital
  • Vidalia, GA
  • NPI 1790376564
  Care Compare affiliation

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1407849706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "615-465-7211",
            "fax_number": "615-628-6877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 FAIR RD STE 102",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580823",
            "telephone_number": "912-764-9001",
            "fax_number": "912-764-3166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "614 E Grady St",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "304582067",
            "country_code": "US",
            "telephone_number": "912-764-9001",
            "fax_number": "912-764-3166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THALLER",
        "first_name": "TIMOTHY",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "046818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000829507B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "340016471",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "782637",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.thaller.1@8824.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "1497 Fair Rd Ste 102",
            "city": "Statesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304580823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Taylor, M.S., LPC
• Technical Diagnostic Imaging, LLC
• John Monroe Templeton Jr., DC
• Rachael Anne Templeton, D.C.
• Tennessee Physician Services, LLC
• Kathryn Ann Thatcher
• THCH Personal Care
• The Neurological Center of East Georgia PC
• The Neurological Institute of Savannah & Center for Spine P C
• The Speech Path of Statesboro, PC

• Urology Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Urology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.