Individual provider Active NPI

Tedra Carolyn Thomas, MD

  • Family Medicine Physician
  • Fayetteville, GA
National Provider Identifier
1821586645
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
89557 Issued in GA
Practice address
730 Glynn St S
Fayetteville, GA 30214-2050
Phone
(770) 460-3650
NPI assigned
Apr 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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 89557 GA Primary

Addresses

Primary practice location

730 Glynn St S
Fayetteville, GA 30214-2050

Mailing address

PO Box 4363
Macon, GA 31208-4363
Phone (478) 787-4266

Other practice location 1

400 Poplar St
Macon, GA 31201-3336
Phone (478) 787-4266

Other identifiers 1

IdentifierTypeStateIssuer
003255700AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200729003450 SC Practitioner - Family Practice 5890049902 Reassigns benefits to 3 organizations
I20240221000754 GA Practitioner - Family Practice 5890049902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Morehouse School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

730 Glynn St S
Fayetteville, GA 30214-2050
Phone (770) 460-3650

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anmed Health Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Anmed Health Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Piedmont Medical Care Corporation Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Peachtree Immediate Care FP, LLC Family Medicine CurrentSince Feb 1, 2024 Accepting new patients
Anmed Health Family Medicine Current Accepting new patients
Anmed Health Current Accepting new patients
Anmed Health Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Anmed Health Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Anmed Health Family Medicine Current Accepting new patients
Peachtree Immediate Care UC, LLC Past Accepting new patients
Piedmont Providers LLC Past Accepting new patients

Locations

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

2768 Watson Blvd
#100
Centerville, GA 31028
Phone (478) 302-0001

730 Glynn St S
Fayetteville, GA 30214
Phone (770) 460-3650

590 Lanier Ave W
Fayetteville, GA 30214

1080 Dawsonville Hwy
#A
Gainesville, GA 30501
Phone (678) 270-1060

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

151 S Houston Lake Rd
Warner Robins, GA 31088
Phone (478) 287-1771

600 N Fant St
Anderson, SC 29621
Phone (864) 512-1787

2000 E Greenville St
Ste 3700
Anderson, SC 29621
Phone (864) 512-1473

1100 W Franklin St
Anderson, SC 29624
Phone (864) 224-0822

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

885 Tiger Blvd
Clemson, SC 29631
Phone (864) 512-4530

Interoperability endpoints

  • Direct secure messaging: tthomas30631@direct.anmedhealth.net

Organizations & group practices 11

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": "1524700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1821586645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4363",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312084363",
            "telephone_number": "478-787-4266",
            "fax_number": "478-787-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 GLYNN ST S",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142050",
            "telephone_number": "770-460-3650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Poplar St",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312013336",
            "country_code": "US",
            "telephone_number": "478-787-4266",
            "fax_number": "478-787-4199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "TEDRA",
        "middle_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-26",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "89557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003255700A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.