Individual provider Active NPI

Clifton Blayne Thomas, MD

  • Family Medicine Physician
  • Moultrie, GA
National Provider Identifier
1659799757
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
074921 Issued in GA
Practice address
3131 S Main St
Moultrie, GA 31768-6925
Phone
(229) 502-9782
NPI assigned
Apr 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 074921 GA Primary

Addresses

Primary practice location

3131 S Main St
Moultrie, GA 31768-6925

Mailing address

PO Box 2876
Moultrie, GA 31776-2876
Phone (229) 502-9782

Other practice location 1

201 W McPherson Ave
Nashville, GA 31639-2131
Phone (229) 638-6726

Other practice location 2

201 Woodrow Wilson Dr
Valdosta, GA 31602-2538
Phone (229) 638-6726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161108001027 FL Practitioner - Family Practice 4688953037 Reassigns benefits to 1 organization
I20170725002556 GA Practitioner - Family Practice 4688953037 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colquitt Regional Hospitalists, LLCGroup PAC ID 0749568780, 28 clinicians
Colquitt Regional Medical CenterGroup PAC ID 6204821796, 20 clinicians

Practice addresses (Care Compare)

3131 S Main St
Moultrie, GA 31768-6925
Phone (229) 502-9782

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
074921GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colquitt Regional Medical Center Family Medicine CurrentSince Apr 20, 2024 Accepting new patients
Patients First Lake Ella Medical Center P a Family Medicine CurrentSince Jun 8, 2023 Accepting new patients
Peachtree Immediate Care FP, LLC Family Medicine CurrentSince Nov 18, 2022 Accepting new patients
Colquitt Regional Hospitalists, LLC CurrentSince Oct 2, 2023 Accepting new patients
Colquitt Regional Pathology, LLC Current Accepting new patients
Colquitt Regional Medical Center CurrentSince Apr 20, 2024 Accepting new patients
Colquitt Regional Medical Center Current Accepting new patients

Locations

2351 Crawfordville Hwy
Crawfordville, FL 32327
Phone (850) 888-0084

3446 Thomasville Rd
Tallahassee, FL 32309
Phone (850) 386-2266

1690 N Monroe St
Tallahassee, FL 32303
Phone (850) 385-2222

1111 Glynco Pkwy
Ste 10
Brunswick, GA 31525
Phone (912) 264-9111

2768 Watson Blvd
#100
Centerville, GA 31028
Phone (478) 302-0001

903 Ward St W
Ste A
Douglas, GA 31533
Phone (912) 260-1191

590 Lanier Ave W
Fayetteville, GA 30214

1275 Highway 54 W
Ste 201
Fayetteville, GA 30214
Phone (770) 461-3776

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

111 Colonial Way
Jesup, GA 31545
Phone (912) 427-8177

3131 Thomasville Hwy
Moultrie, GA 31768
Phone (229) 502-9769

275 Perry Pkwy
Perry, GA 31069
Phone (478) 218-7582

275 Perry Pkwy
Ste G
Perry, GA 31069

586 Brannen St
Statesboro, GA 30458
Phone (912) 871-6611

1430 US Highway 82 W
Tifton, GA 31793
Phone (229) 333-9736

3281 Inner Perimeter Rd
Valdosta, GA 31602
Phone (229) 671-9100

1912 Memorial Dr
Waycross, GA 31501
Phone (912) 283-7100

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: clifton.thomas@104014667710468.direct.elationemr.com

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1659799757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2876",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317762876",
            "telephone_number": "229-502-9782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 S MAIN ST",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317686925",
            "telephone_number": "229-502-9782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 W McPherson Ave",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "GA",
            "postal_code": "316392131",
            "country_code": "US",
            "telephone_number": "229-638-6726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Woodrow Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "Valdosta",
            "state": "GA",
            "postal_code": "316022538",
            "country_code": "US",
            "telephone_number": "229-638-6726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CLIFTON",
        "middle_name": "BLAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "074921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moultrie, GA

Sources for this page

Verify at the official NPI Registry.