Mark Shannon Thomas

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

Practice address

2124 Fountain SQ
Snellville, GA 30078-3196

Phone

(770) 689-9788

NPI assigned

Dec 20, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Mark Shannon King Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• King 1959, Inc.

  dba Diabetic Relief

  • Durable Medical Equipment & Medical Supplies
  • Conyers, GA
  • NPI 1780174821
  NPD (past) Authorized official

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

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1811233794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 GEES MILL RD NE STE 313",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300131363",
            "telephone_number": "770-689-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 FOUNTAIN SQ",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783196",
            "telephone_number": "770-689-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MARK",
        "middle_name": "SHANNON",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-20",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "KING",
            "middle_name": "SHANNON",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Thomas W. Bantly, M.D., P.C
• Abel Thomas, CPHT
• Cherrell D Thomas, LPC, NCC
• Keldreca Shuntae Thomas, FNP
• Makyla Elise Thomas
• Melissa Ann Thomas, RDN, LD, CLC
• Rachel Thomas
• Wilma Thomas, C.R.N.A.
• Thompson Home Healthcare LLC
• Constance J. Thompson, R.N.

• Surgical Technologist in Snellville, GA
• Providers in Snellville, GA by specialty
• Surgical Technologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.