Tommy Lee Tally, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

POD001388 Issued in GA

Practice address

1300 Peachtree Industrial Blvd Ste 4105
Suwanee, GA 30024-4541

Phone

(470) 589-1204

Fax

(470) 589-1465

NPI assigned

Oct 10, 2018

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 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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Western University of Health Sciences College of Dental Med, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emory Johns Creek Hospital Hospital, Johns Creek, GA, CCN 110230
• Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
• Direct secure messaging: ttally@sfaas-ga.direct.office.nextgen.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.

• Suwanee Foot and Ankle Specialists LLC

  • Foot & Ankle Surgery Podiatrist
  • Suwanee, GA
  • NPI 1184292138

  Single Specialty

  Medicare reassignment NPD Authorized official
• Metro Foot and Ankle Centers, PC

  • Foot & Ankle Surgery Podiatrist
  • Lithonia, GA
  • NPI 1598097149
  Medicare reassignment
• Georgia Vascular Institute, LLC

  • Vascular & Interventional Radiology Physician
  • Atlanta, GA
  • NPI 1912136524

  Single Specialty

  NPD (past)

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

• Ehca Johns Creek, LLC

  dba Emory Johns Creek Hospital

  • General Acute Care Hospital
  • Johns Creek, GA
  • NPI 1679632137
  Care Compare affiliation
• Kennestone Hospital, Inc.

  dba Wellstar Windy Hill Hospital

  • Long Term Care Hospital
  • Marietta, GA
  • NPI 1700853041

  Long-term care hospital

  Care Compare affiliation

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1427523919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 PEACHTREE INDUSTRIAL BLVD STE 4105",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244541",
            "telephone_number": "470-589-1204",
            "fax_number": "470-598-1465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 PEACHTREE INDUSTRIAL BLVD STE 4105",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244541",
            "telephone_number": "470-589-1204",
            "fax_number": "470-589-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLY",
        "first_name": "TOMMY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-10",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD001388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003219790A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Sytsma
• Khanh Ta
• Nedim Tabakovic, RBT
• Ngano Tongesai Frank Takawira, MD
• Kelly Tally, DPM
• Lee R Tanenbaum, M.A., CCC
• Linda Tang, FNP-C
• Qiansha Tang, PHARM.D
• Thanh Tang, DMD
• Karen Tantillo, LCSW

• Foot & Ankle Surgery Podiatrist in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Foot & Ankle Surgery Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.