DR. THOMAS M FASSULIOTIS (NPI# 1821014291) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821014291 |
| Entity Type | Individual |
| Full Name | DR. THOMAS M FASSULIOTIS |
| Credential | M.D. |
| Practice Address |
1240 Jesse Jewell Pkwy Se Suite 200 Gainesville GA 30501-3862 |
| Practice Telephone | 7705328438 |
| Practice Fax Number | 7705351785 |
| Mailing Telephone | 7705328438 |
| Mailing Fax Number | 7705351785 |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2012-05-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 28540 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1240 JESSE JEWELL PKWY SE SUITE 200 |
| City | GAINESVILLE |
| State | GA |
| Zip Code | 30501-3862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609879881 | C. Shane Bussler | Internal Medicine | 1240 Jesse Jewell Pkwy Se, Ste 500, Gainesville, GA 30501-3861 | 2005-05-23 |
| 1346780251 | Ashley Wilkins | Physician Assistant | 1240 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3862 | 2017-02-27 |
| 1962948422 | Charlsie A Thomas | Physician Assistant | 1240 Jesse Jewell Pkwy Se, Suite 500, Gainesville, GA 30501-3862 | 2017-01-09 |
| 1780128272 | Lauren H Darnell | Nurse Practitioner | 1240 Jesse Jewell Pkwy Se, Suite 500, Gainesville, GA 30501-3862 | 2016-12-19 |
| 1912452061 | Kristina Stefanova James | Nurse Practitioner | 1240 Jesse Jewell Pkwy Se, Suite 400, Gainesville, GA 30501-3862 | 2016-08-18 |
| 1124486238 | Brandon Lee Morrow | Physician Assistant | 1240 Jesse Jewell Pkwy Se, Ste 300, Gainesville, GA 30501-3862 | 2016-02-03 |
| 1427413962 | Sherry Hope Flanagan | Nurse Practitioner | 1240 Jesse Jewell Pkwy Se, Suite 500, Gainesville, GA 30501-3862 | 2015-12-29 |
| 1457757593 | Colleen Mccoy | Physician Assistant | 1240 Jesse Jewell Pkwy Se, Gainesville, GA 30501 | 2014-11-18 |
| 1689009953 | Ernie Loza Aldaco | Registered Nurse | 1240 Jesse Jewell Pkwy Se, Suite 300, Gainesville, GA 30501-3862 | 2013-09-05 |
| 1871838375 | Laura J Johansen | Physical Therapist | 1240 Jesse Jewell Pkwy Se, Suite 500, Gainesville, GA 30501-3862 | 2012-12-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437782851 | Madison Raye Huth | Physician Assistant | 743 Spring Street Se, Gainesville, GA 30501 | 2020-02-13 |
| 1205487659 | Grace M Walker Brown | Nurse Practitioner | 592 Medical Park Dr., Suite A, Gainesville, GA 30501 | 2019-09-26 |
| 1174086987 | Nayab Ahmed | Student in an Organized Health Care Education/Training Program | 743 Spring Street, Suite 710, Gainesville, GA 30501 | 2019-04-09 |
| 1154881118 | Ryan D Berry | Student in an Organized Health Care Education/Training Program | 734 Spring St Se Ste 710, Gainesville, GA 30501 | 2019-03-24 |
| 1609336304 | Harper E Niver | Student in an Organized Health Care Education/Training Program | 743 Spring St., Suite 710, Gainesville, GA 30501 | 2019-03-20 |
| 1508336173 | Bradee Burrell Aderholt | Nurse Practitioner | 663 Lanier Park Drive, Gainesville, GA 30501 | 2018-11-27 |
| 1578068359 | Soammy Liz Matias | Chiropractor | 961 Green Street, Gainesville, GA 30501 | 2018-03-26 |
| 1811496896 | Matthew Brown | Speech-Language Pathologist | 500 Spring St. Se Suite 101, Gainesville, GA 30501 | 2018-02-06 |
| 1346769825 | Dr. Skeete & Associates of North Georgia, P.C. | Optometrist | 150 Pearl Nix Parkway, Suite D3a, Gainesville, GA 30501 | 2017-09-15 |
| 1932624723 | M & B Imaging, PC | Radiology | 1640 Jesse Jewell Pkwy Se Ste 2, Gainesville, GA 30501 | 2017-08-14 |
| Find all providers in zip 30501 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386059368 | Jonathan Wirick Angelle | Urology | 1240 Jesse Jewell Pkwy Se Ste 200, Gainesville, GA 30501-3861 | 2014-06-27 |
| 1164849303 | Julia Han | Urology | 1600 Sw Archer Rd Rm N-203, Gainesville, FL 32610-0247 | 2014-03-26 |
| 1083635494 | Perinchery Narayan | Urology | 3426 Nw 43rd St, Suite B, Gainesville, FL 32606-8105 | 2006-07-21 |
| 1528084183 | Christopher Michael Cassisi | Urology | 6420 Nw 9 Blvd, Gainesville, FL 32605 | 2006-07-15 |
| 1669415667 | Sean Patrick Mclaughlin | Urology | 6420 Nw 9th Blvd, Gainesville, FL 32605-4203 | 2006-06-14 |
| 1821041476 | Brent A Sharpe | Urology | 660 Lanier Park Dr Ste A, Gainesville, GA 30501-2075 | 2006-05-17 |
| 1639128168 | Martin Neil Rifkin | Urology | 1179 Nw 64th Ter, Gainesville, FL 32605-4218 | 2006-05-10 |
| 1114926912 | Ronald Leroy Brock | Urology | 660 Lanier Park Drive, Ste A, Gainesville, GA 30501-2075 | 2005-07-14 |
| 1063419281 | William Bird Jones | Urology | 660-a Lanier Park Drive, Gainesville, GA 30501-2075 | 2005-07-01 |
| 1770104473 | Advanced Urology Institute of Georgia PC | Urology | 601 Broad St Se Ste B, Gainesville, GA 30501-3718 | 2020-05-04 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 30501 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.