Organization Active NPI

TMB Medical Associates, P.C.

  • Internal Medicine Physician
  • Watkinsville, GA
National Provider Identifier
1649413055
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
043880 Issued in GA
Legal business name
TMB MEDICAL ASSOCIATES, P.C.
Practice address
1181 Langford Dr
BLDG 200 Ste 105
Watkinsville, GA 30677-7304
Phone
(706) 548-9655
Fax
(706) 548-9769
NPI assigned
Apr 15, 2009
Last updated
Feb 16, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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

Authorized official

Name
Toby M Bond, M.D.NPI 1467463513
Title
Provider/Owner
Phone
(706) 548-9655

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 119157 GA
Family Nurse Practitioner 363LF0000X 175504 GA
Internal Medicine Physician 207R00000X 043880 GA Primary

Addresses

Primary practice location

1181 Langford Dr
BLDG 200 Ste 105
Watkinsville, GA 30677-7304

Mailing address

1181 Langford Dr
BLDG 200 Ste 105
Watkinsville, GA 30677-7304
Phone (706) 548-9655

Other identifiers 1

IdentifierTypeStateIssuer
043880OtherGASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090622000112 GA Part B Supplier - Clinic/Group Practice 6406907088 Receives reassigned benefits from 2 practitioners
Practice locations: Athens, GA; Watkinsville, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1107418TMB Medical Associates PC1181 Langford Drive, BLDG 200, Suite 105, Watkinsville, GA 30677Provider-performed microscopyNov 4, 2027

National Provider Directory

National Provider Directory

Locations

1181 Langford Dr
Bldg 105
Watkinsville, GA 30677

1181 Langford Dr
Bldg 200
Watkinsville, GA 30677
Phone (706) 548-9655

1181 Langford Dr
Ste 105
Watkinsville, GA 30677
Phone (706) 548-9655

1181 Langford Dr
Ste 200
Watkinsville, GA 30677

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CGFHAA

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1239753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487203200000",
    "number": "1649413055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1181 LANGFORD DR",
            "address_2": "BLDG 200 STE 105",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777304",
            "telephone_number": "706-548-9655",
            "fax_number": "706-548-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 LANGFORD DR",
            "address_2": "BLDG 200 STE 105",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777304",
            "telephone_number": "706-548-9655",
            "fax_number": "706-548-9769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TMB MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-15",
        "last_updated": "2017-02-16",
        "status": "A",
        "authorized_official_last_name": "BOND",
        "authorized_official_first_name": "TOBY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "706-548-9655",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "119157",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "175504",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "043880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "043880",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.