Active NPI
Eddie D. Thomas, M.D.
- Pediatrics Physician
- Jesup, GA
National Provider Identifier
1730159591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 053192
- Practice address
- 391 Peachtree St
Jesup, GA 31545-0245 - Phone
- (912) 530-7337
- Fax
- (912) 530-7339
- NPI assigned
- Jan 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 053192 | GA | Primary |
Addresses
Primary practice location
391 Peachtree St
Jesup, GA 31545-0245
Mailing address
391 Peachtree St
Jesup, GA 31545-0304
Phone (912) 530-7337
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 798956032A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053192 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neighborhood Pediatrics | Pediatrics | Current | Accepting new patients |
| Dr. Eddie D. Thomas, M.D.,P.C. | Pediatrics | Current | Accepting new patients |
| Stanley D. Jones, M.D.P.C. | Pediatrics | Past | Accepting new patients |
Locations
125 Hobbs St
Blackshear, GA 31516
Phone (912) 530-7337
391 Peachtree St
Jesup, GA 31545
Phone (912) 530-7337
Organizations & group practices 3
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506038400000",
"number": "1730159591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "391 PEACHTREE ST",
"city": "JESUP",
"state": "GA",
"postal_code": "315450304",
"telephone_number": "912-530-7337",
"fax_number": "912-530-7339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "391 PEACHTREE ST",
"city": "JESUP",
"state": "GA",
"postal_code": "315450245",
"telephone_number": "912-530-7337",
"fax_number": "912-530-7339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "EDDIE",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2017-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "053192",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "798956032A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jesup, GA
- Joanie Swanson, CCC-SLP
- Kathleen Deal Tatum, LCSW
- William Ralph Taylor III
- The Howard Center for Social Cognition and Communication
- The Neurological Institute of Savannah & Center for Spine P C
- James Derryl Thomas, O.D.
- Kristi M Thompson, PT
- Ashley Strock Thrift, RBT
- Tim'S Home Medical LLC
- Chance Stewart Tiner, NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.