Thomas W McCormack Jr., MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

GA051255 Issued in GA

Practice address

1361 Jennings Mill Road
Building 200 Suite 201
Bogart, GA 30622

Phone

(706) 316-1908

Fax

(706) 316-2062

NPI assigned

Aug 4, 2006

Last updated

Jul 8, 2007By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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 1

Specialty

Psychiatry

Education

Emory University School of Medicine, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: athensbehavioralmedicine.tommccormack@151513.advancedmd-direct.com

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.

• Athens Behavioral Medicine

  • Psychiatry Physician
  • Bogart, GA
  • NPI 1902026347
  Medicare reassignment NPD
• Georgia TRD Clinic, LLC

  • Psychiatry Physician
  • Watkinsville, GA
  • NPI 1376222075
  NPD Authorized official
• Advantage Behavioral Health Systems

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Athens, GA
  • NPI 1942270558
  NPD (past)
• Edward J Fisher Jr MD Inc

  • Psychiatry Physician
  • Bogart, GA
  • NPI 1083736961
  NPD (past)

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

• Piedmont Athens Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Athens, GA
  • NPI 1437186111
  Care Compare affiliation

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740298728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 JENNINGS MILL ROAD",
            "address_2": "BUILDING 200 SUITE 201",
            "city": "BOGART",
            "state": "GA",
            "postal_code": "30622",
            "telephone_number": "706-316-1908",
            "fax_number": "706-316-2062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 JENNINGS MILL ROAD",
            "address_2": "BUILDING 200 SUITE 201",
            "city": "BOGART",
            "state": "GA",
            "postal_code": "30622",
            "telephone_number": "706-316-1908",
            "fax_number": "706-316-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMACK",
        "first_name": "THOMAS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "GA051255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00958625A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark a Ellis, MD, PC
• Janet Stillman Martin, PH.D.
• Sam Luke Martin, PHARMD
• Toni L Mason, PH.D.
• Van Scott McCorkle, MD
• Tymichia McGill
• Virginia McKenna, M.ED.
• Megan Milian
• Deborah C Miller, APRN BC
• Ivy Mitchell

• Psychiatry Physician in Bogart, GA
• Providers in Bogart, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.