Individual provider Active NPI

Abraham Chempakanallore Thomas, M.D.

  • Diagnostic Radiology Physician
  • Marietta, GA
National Provider Identifier
1982839593
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
77955 Issued in GA
Practice address
790 Church St NE Ste 400
Marietta, GA 30060-8957
Phone
(770) 405-2976
NPI assigned
May 27, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301095927 MI
Diagnostic Radiology Physician 2085R0202X 77955 GA Primary

Addresses

Primary practice location

790 Church St NE Ste 400
Marietta, GA 30060-8957

Mailing address

PO Box 3157
Indianapolis, IN 46206-3157
Phone (770) 405-2976

Other practice location 1

1500 E Medical Center Dr
Room UH B1-D502
Ann Arbor, MI 48109-5000
Phone (734) 615-4924

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
I20170914002051 GA Practitioner - Diagnostic Radiology 3678796299 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quantum Radiology PCGroup PAC ID 4385543230, 105 clinicians

Practice addresses (Care Compare)

1120 Wellstar Way
Holly Springs, GA 30114-8929
Phone (678) 239-0420

1170 Cleveland Ave
East Point, GA 30344-3615
Phone (678) 239-0420

1625 Hospital N Dr
Suite 150
Austell, GA 30106-8111
Phone (770) 944-0466

2450 Old Milton Pkwy
Suite 101
Alpharetta, GA 30009-2108
Phone (678) 239-0420

3000 Hospital Blvd
Roswell, GA 30076-4915
Phone (770) 751-2500

3747 Roswell Rd
Marietta, GA 30062-6215
Phone (470) 956-8765

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4000

60 Lacy St NW
Marietta, GA 30060-1112
Phone (770) 793-7800

677 Church St NE
Marietta, GA 30060-1101
Phone (770) 793-5000

925 Sanders Rd
Suite B
Cumming, GA 30041-7945
Phone (678) 513-0500

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Wellstar North Fulton Medical Center Hospital, Roswell, GA, CCN 110198
  • Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77955GAMDDiagnostic Radiology Physician
4301095927MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Health Imaging of Georgia, LLC CurrentSince Sep 5, 2017 Accepting new patients
Quantum Radiology, PC Diagnostic Radiology CurrentSince Sep 3, 2017 Accepting new patients
Synergy Radiology, LLC Diagnostic Radiology CurrentSince Jun 26, 2018 Accepting new patients
American Health Imaging of Georgia LLC CurrentSince Sep 5, 2017 Accepting new patients
Diagnostic Systems Inc Diagnostic Radiology PastSince Feb 18, 2019 Accepting new patients
Wellstar Medical Group, LLC Past Accepting new patients
Synergy Radiology, LLC PastSince Jul 21, 2024 Accepting new patients

Locations (25 of 59)

4550 Cobb Parkway North NW
Ste 109
Acworth, GA 30101
Phone (470) 956-0079

12460 Crabapple Rd
Alpharetta, GA 30004
Phone (678) 762-0574

2450 Old Milton Pkwy
Alpharetta, GA 30009
Phone (470) 267-0360

5655 Atlanta Hwy
Alpharetta, GA 30004
Phone (770) 691-0819

3730 Carmia Dr SW
Ste 110
Atlanta, GA 30331
Phone (404) 344-7286

3890 Redwine Rd SW
Ste 104
Atlanta, GA 30331
Phone (404) 629-4700

1680 Hospital South Dr
Austell, GA 30106
Phone (678) 945-2100

1025 E West Connector
Ste 520
Austell, GA 30106
Phone (678) 273-3071

1625 Hospital North Dr
Austell, GA 30106
Phone (770) 732-6950

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1501 Milstead Rd NE
Ste 140
Conyers, GA 30012

925 Sanders Rd
Cumming, GA 30041
Phone (404) 567-6500

120 Greystone Power Blvd
Dallas, GA 30157
Phone (470) 267-1540

8954 Hospital Dr
Douglasville, GA 30134
Phone (678) 838-2584

6002 Professional Pkwy
Ste 260
Douglasville, GA 30134
Phone (470) 644-5411

6001 Professional Pkwy
Douglasville, GA 30134
Phone (404) 274-7335

4244 Washington Rd
Evans, GA 30809
Phone (706) 619-1869

307 W Robinson Ave
Grovetown, GA 30813

2518 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (470) 644-7000

144 Bill Carruth Pkwy
Hiram, GA 30141

148 Bill Carruth Pkwy
Ste LL20
Hiram, GA 30141
Phone (770) 443-7700

1120 Wellstar Way
Holly Springs, GA 30114

1550 Kennesaw Due West Rd NW
Kennesaw, GA 30152
Phone (770) 423-9525

3805 Cherokee St NW
Kennesaw, GA 30144
Phone (770) 426-5665

3980 Jiles Rd NW
Kennesaw, GA 30144
Phone (678) 504-0100

Organizations & group practices 9

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": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1982839593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3157",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462063157",
            "telephone_number": "770-405-2976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 CHURCH ST NE STE 400",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608957",
            "telephone_number": "770-405-2976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 E Medical Center Dr",
            "address_2": "Room UH B1-D502",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481095000",
            "country_code": "US",
            "telephone_number": "734-615-4924",
            "fax_number": "734-763-9523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ABRAHAM",
        "middle_name": "CHEMPAKANALLORE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-27",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301095927",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "77955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.