NPIMap

Individual provider Active NPI

Thomas R Mann, M.D.PC

  • Internal Medicine Physician
  • Fitzgerald, GA
National Provider Identifier
1740370691
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
GA37607 Issued in GA
Practice address
118 Norman Dorminy Drive
Fitzgerald, GA 31750
Phone
(229) 424-0134
Fax
(229) 424-9383
NPI assigned
Oct 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X GA37607 GA Primary

Addresses

Primary practice location

118 Norman Dorminy Drive
Fitzgerald, GA 31750

Mailing address

118 Norman Dorminy Dr
Fitzgerald, GA 31750-8858
Phone (229) 423-9561

Other identifiers 1

IdentifierTypeStateIssuer
000617251AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091228000302 GA Practitioner - Internal Medicine 9739283052 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Georgia School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DMC Physician Group LLCGroup PAC ID 8628296845, 20 clinicians

Practice addresses (Care Compare)

182 Perry House Rd H
Fitzgerald, GA 31750-8721
Phone (229) 423-9561

200 Perry House Rd
Fitzgerald, GA 31750-8857
Phone (229) 424-7100

PO Box
Suite 1447
Fitzgerald, GA 31750

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
GA37607GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DMC Physician Group LLC Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients
Phoebe Physiatry CurrentSince May 1, 2011 Accepting new patients
Phoebe Physician Group, Inc CurrentSince May 1, 2011 Accepting new patients
DMC Physician Group LLC CurrentSince Jul 1, 2014 Accepting new patients
Optimal Performance and Physical Therapies Palm Harbor LLC PastSince May 16, 2011 Accepting new patients
DMC Physician Group LLC Internal Medicine Past Accepting new patients
Hospital Authority of Ben Hill Past Accepting new patients

Locations

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

118 Norman Dorminy Dr
Fitzgerald, GA 31750
Phone (229) 423-9561

182 Perry House Rd
Ste H
Fitzgerald, GA 31750
Phone (229) 423-9561

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 5

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1740370691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 NORMAN DORMINY DR",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317508858",
            "telephone_number": "229-423-9561",
            "fax_number": "229-424-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 NORMAN DORMINY DRIVE",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "31750",
            "telephone_number": "229-424-0134",
            "fax_number": "229-424-9383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "THOMAS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "GA37607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000617251A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitzgerald, GA

Sources for this page

Verify at the official NPI Registry.