Organization Active NPI

Dr. Thomas R Fitzsimmons MD PC

  • Surgery Physician
  • Stockbridge, GA
National Provider Identifier
1649516006
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
056566 Issued in GA
Legal business name
DR. THOMAS R FITZSIMMONS MD PC
Practice address
1215 Eagles Landing Parkway
Suite 105
Stockbridge, GA 30281
Phone
(770) 997-5347
Fax
(678) 289-0191
NPI assigned
Dec 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Authorized official

Name
Dr. Thomas R. Fitzsimmons, M.D.
Title
Ceo/Owner
Phone
(770) 997-5347

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 056566 GA Primary

Addresses

Primary practice location

1215 Eagles Landing Parkway
Suite 105
Stockbridge, GA 30281

Mailing address

1215 Eagles Landing Parkway
Suite 105
Stockbridge, GA 30281
Phone (770) 997-5347

Other identifiers 1

IdentifierTypeStateIssuer
783252541CMedicaidGA

Other names 1

  • Thomas R Fitzsimmons MD PC Doing business as

National Provider Directory

National Provider Directory

Locations

245 Village Center Pkwy
Ste 100
Stockbridge, GA 30281
Phone (770) 389-1962

7444 Hannover Pkwy S
Ste 225
Stockbridge, GA 30281
Phone (404) 981-3376

NPI Registry JSON

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

{
    "created_epoch": "1355270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600041600000",
    "number": "1649516006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 EAGLES LANDING PARKWAY",
            "address_2": "SUITE 105",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-997-5347",
            "fax_number": "678-289-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 EAGLES LANDING PARKWAY",
            "address_2": "SUITE 105",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-997-5347",
            "fax_number": "678-289-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. THOMAS R FITZSIMMONS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-12",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A",
        "authorized_official_last_name": "FITZSIMMONS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "770-997-5347",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "GA",
            "license": "056566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "783252541C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thomas R Fitzsimmons MD PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.