Thomas John Maytum Jr., PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA001065 Issued in GA

Practice address

1225 Broadrick Dr
Dalton, GA 30720-2504

Phone

(706) 272-6199

Fax

(706) 272-6291

NPI assigned

Sep 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1598950206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 BROADRICK DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202504",
            "telephone_number": "706-272-6199",
            "fax_number": "706-272-6291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 BROADRICK DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202504",
            "telephone_number": "706-272-6199",
            "fax_number": "706-272-6291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYTUM",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA001065",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA15969",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therese A Maxwell, MD
• William S Mayberry, MD
• Linda J Mayes, LCSW
• Jan Renee Mayfield, MD
• Ginny Lee Mayher, SLP
• MC Medical LLC (Walmart Health)
• McAmis Anesthesia Consultants
• Alison McBride, NP
• Daniel James McBride, OD
• Rebecca McBride, OT/L

• Physical Therapy Assistant in Dalton, GA
• Providers in Dalton, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.