Individual provider Active NPI

Dennis Russell Thomas, M.D.

  • Family Medicine Physician
  • Valdosta, GA
National Provider Identifier
1821031329
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
022898 Issued in GA
Practice address
4370 Kings Way
Valdosta, GA 31602-6904
Phone
(229) 433-8181
Fax
(229) 293-7801
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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 022898 GA Primary

Addresses

Primary practice location

4370 Kings Way
Valdosta, GA 31602-6904

Mailing address

4370 Kings Way
Valdosta, GA 31602-6904
Phone (229) 433-8181

Other identifiers 3

IdentifierTypeStateIssuer
117939MedicaidGA
000260809EMedicaidGA
336042MedicaidGA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050303000847 GA Practitioner - Family PracticePractitioner - Emergency Medicine 8729032685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Medical College of Georgia School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
SGMC Physician Network IncGroup PAC ID 4082036843, 128 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

4370 Kings Way
Suite E
Valdosta, GA 31602-6905
Phone (229) 433-8181

Hospital & facility affiliations

  • Crescent Home Health Home health agency, Adel, GA, CCN 117087
  • Amedisys Home Health of Valdosta Home health agency, Valdosta, GA, CCN 117114
  • Georgia Home Health Services Home health agency, Valdosta, GA, CCN 117058
  • SGMC Health Hospital, Valdosta, GA, CCN 110122

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of Valdosta and Lowndes County Georgia Current Accepting new patients
SGMC Affiliated Services LLC Current Accepting new patients
SGMC Physician Network Inc Family Medicine CurrentSince Nov 1, 2020 Accepting new patients
Sheridan Emergency Physician Services of Georgia,LLC Past Accepting new patients
United Emergency Services, Inc. Past Accepting new patients
Emergency Medicine South LLC Past Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1221 E McPherson Ave
Nashville, GA 31639
Phone (229) 543-7100

4280 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 433-7350

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

2501 N Ashley St
Valdosta, GA 31602
Phone (229) 224-7368

520 Griffin Ave
Valdosta, GA 31601
Phone (229) 245-0020

4370 Kings Way
Ste E
Valdosta, GA 31602
Phone (229) 247-7177

410 Northside Dr
Valdosta, GA 31602
Phone (229) 242-7368

Organizations & group practices 8

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1821031329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 KINGS WAY",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026904",
            "telephone_number": "229-433-8181",
            "fax_number": "229-293-7801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 KINGS WAY",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316026904",
            "telephone_number": "229-433-8181",
            "fax_number": "229-293-7801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "DENNIS",
        "middle_name": "RUSSELL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "022898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117939",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000260809E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336042",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.