Individual provider Active NPI

Robert W Thompson, MD

  • Pediatrics Physician
  • Atlanta, GA
National Provider Identifier
1952329492
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
052647 Issued in GA
Practice address
1001 Johnson Ferry Rd NE
Atlanta, GA 30342
Phone
(678) 344-1960
Fax
(404) 785-4969
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 052647 GA Primary

Addresses

Primary practice location

1001 Johnson Ferry Rd NE
Atlanta, GA 30342

Mailing address

441 Lantern Wood Dr
Scottdale, GA 30079
Phone (404) 299-7539

Other identifiers 1

IdentifierTypeStateIssuer
216013323MedicaidGA

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
I20150504002178 GA Practitioner - Pediatric Medicine 2264451004 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
052647GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC CurrentSince Jan 1, 2015 Accepting new patients

Locations

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

1001 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 785-2008

Interoperability endpoints

  • Direct secure messaging: rthompson5792@choa.gadirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1952329492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 LANTERN WOOD DR",
            "city": "SCOTTDALE",
            "state": "GA",
            "postal_code": "30079",
            "telephone_number": "404-299-7539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 JOHNSON FERRY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "678-344-1960",
            "fax_number": "404-785-4969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "052647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "216013323",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.