Individual provider Active NPI

Thomas Ellis Reeve IV, M.D.

  • Vascular Surgery Physician
  • Carrollton, GA
National Provider Identifier
1992940217
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
79319 Issued in GA
Practice address
157 Clinic Ave Ste 302
Carrollton, GA 30117
Phone
(770) 812-5902
Fax
(770) 812-5903
NPI assigned
Dec 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 79319 GA Primary

Addresses

Primary practice location

157 Clinic Ave Ste 302
Carrollton, GA 30117

Mailing address

706 Dixie St Ste 220
Carrollton, GA 30117-3858
Phone (770) 838-8710

Other practice location 1

1365 Clifton Rd NE Bldg A
Atlanta, GA 30322
Phone (404) 727-1994

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
I20200602001438 GA Practitioner - Vascular Surgery 4284998527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Mercer University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

157 Clinic Ave
Suite 302C
Carrollton, GA 30117-4454
Phone (770) 838-3336

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal30
Leg revascularization (restoring blood flow)13
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79319GAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Medical Group Inc Vascular Surgery CurrentSince Jun 30, 2020 Accepting new patients
TMC Children's Healthcare of West Georgia Past Accepting new patients
Tanner Medical Center, Inc Past Accepting new patients

Locations

157 Clinic Ave
Ste 302
Carrollton, GA 30117
Phone (770) 812-5902

706 Dixie St
Ste 220
Carrollton, GA 30117
Phone (770) 812-8825

157 Clinic Ave
Ste 302C
Carrollton, GA 30117
Phone (770) 834-3336

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

690 Dallas Hwy
Ste 207B
Villa Rica, GA 30180
Phone (770) 812-5902

Organizations & group practices 3

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": "1229385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1992940217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 DIXIE ST STE 220",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173858",
            "telephone_number": "770-838-8710",
            "fax_number": "770-812-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 CLINIC AVE STE 302",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "30117",
            "telephone_number": "770-812-5902",
            "fax_number": "770-812-5903"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1365 Clifton Rd NE Bldg A",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30322",
            "country_code": "US",
            "telephone_number": "404-727-1994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REEVE",
        "first_name": "THOMAS",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-16",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "79319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.