NPIMap

Organization Active NPI

Thomasville Regional Medical Associates LLC

Doing business as Thomasville Regional Emergency Medicine

  • Emergency Medicine Physician
  • Thomasville, AL
National Provider Identifier
1972231314
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
THOMASVILLE REGIONAL MEDICAL ASSOCIATES LLC
Doing business as
Thomasville Regional Emergency Medicine
Practice address
300 Med Park Drive
Mob Suite D
Thomasville, AL 36784-5760
Phone
(334) 636-2525
NPI assigned
Aug 12, 2022
Last updated
Aug 12, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
THOMASVILLE REGIONAL MEDICAL ASSOCIATES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Authorized official

Name
Breanna Brickner
Title
Controller
Phone
(205) 903-2392

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

300 Med Park Drive
Mob Suite D
Thomasville, AL 36784-5760

Mailing address

300 Med Park Drive
Mob Suite D
Thomasville, AL 36784-5760

Other names 1

  • Thomasville Regional Emergency Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221020002815 AL Part B Supplier - Clinic/Group Practice 4688096266 Receives reassigned benefits from 8 practitioners
Practice locations: Thomasville, AL

National Provider Directory

National Provider Directory
Tax ID family
Thomasville Regional Medical Associates LLC2 organizations share this tax ID, including this one
Part of
Thomasville Regional Medical Associates LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

300 Med Park Dr
Thomasville, AL 36784
Phone (334) 456-6458

300 Med Park Dr
Ste D
Thomasville, AL 36784
Phone (334) 636-2525

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660262400000",
    "number": "1972231314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MED PARK DRIVE",
            "address_2": "MOB SUITE D",
            "city": "THOMASVILLE",
            "state": "AL",
            "postal_code": "367845760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MED PARK DRIVE",
            "address_2": "MOB SUITE D",
            "city": "THOMASVILLE",
            "state": "AL",
            "postal_code": "367845760",
            "telephone_number": "334-636-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMASVILLE REGIONAL MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THOMASVILLE REGIONAL MEDICAL ASSOCIATES LLC",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A",
        "authorized_official_last_name": "BRICKNER",
        "authorized_official_first_name": "BREANNA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "205-903-2392"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thomasville Regional Emergency Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thomasville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.