Thomas Wayne Bloodworth, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

018124 Issued in GA

Practice address

6794 Bill Carruth Parkway
Hiram, GA 30141

Phone

(678) 567-5917

Fax

(770) 222-4589

NPI assigned

Jul 23, 2010

Last updated

Aug 11, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• First Doctors Weight Loss

  • Primary Care Clinic/Center
  • Hiram, GA
  • NPI 1104285980
  NPD (past)

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439251200000",
    "number": "1619280278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6794 BILL CARRUTH PARKWAY",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "30141",
            "telephone_number": "678-567-5917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6794 BILL CARRUTH PARKWAY",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "30141",
            "telephone_number": "678-567-5917",
            "fax_number": "770-222-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOODWORTH",
        "first_name": "THOMAS",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-23",
        "last_updated": "2015-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "018124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Eric Bentley, CO, LO
• Kelly L Betances, RPSGT
• Sharon Bingham-Shultz, D.M.D.
• Dana Bivens
• Blessed Healthcare Services of Georgia, LLC
• Blue Wave Medical Supply, LLC
• Kristin Boatner, OT
• Jason Boldt, LDO
• Vanessa H Bonaparte, LPC
• Shelbie Monique Boston

• Obstetrics & Gynecology Physician in Hiram, GA
• Providers in Hiram, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; 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.