Thomas C Crouch (NPI# 1073889853, PAC ID# 0345535878) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1073889853 |
| PAC ID by PECOS | 0345535878 |
| Professional Enrollment ID | I20181205001604 |
| Full Name | Thomas C Crouch |
| Organization Legal Name | THE BORTOLAZZO GROUP, LLC |
| Address |
3950 Austell Rd Austell GA 30106-1121 |
| Phone Number | 7707324000 |
| Gender | M |
| Medical School | UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF MEDICINE |
| Graduation Year | 2012 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 3476554320 |
| Number of Group Practice Members | 55 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110042 | WELLSTAR PAULDING HOSPITAL |
| 110184 | WELLSTAR DOUGLAS HOSPITAL |
| 110143 | WELLSTAR COBB HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3950 Austell Rd, Austell, GA 30106-1121 | 7707324000 | THE BORTOLAZZO GROUP, LLC |
| Organization Legal Name | THE BORTOLAZZO GROUP, LLC |
| Physicians | 54 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Henry C Nygren | Emergency Medicine | The Bortolazzo Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Audrey C M Williams | Emergency Medicine | The Bortolazzo Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Brett H Cannon | Emergency Medicine | The Bortolazzo Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Steven B Core | Emergency Medicine | The Bortolazzo Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Latanya Taneia Gobin | Emergency Medicine | The Bortolazzo Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Nirma D Bustamante | Emergency Medicine | The Bortolazzo Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Jazmin S Raadsen | Nurse Practitioner | The Bortolazzo Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Nicholas Allen Hooper | Emergency Medicine | The Bortolazzo Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Tariq Noohani | Emergency Medicine | The Bortolazzo Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Karim Ali | Emergency Medicine | The Bortolazzo Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Street Address |
3950 AUSTELL RD |
| City | AUSTELL |
| State | GA |
| Zip | 30106-1121 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bhavik D Mehta | Anesthesiology Assistant | Mak Anesthesia Holdings, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Reza H Mohammad | Anesthesiology Assistant | Mak Anesthesia Holdings, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Y Khalid Siddiq | Endocrinology | Wellstar Medical Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Yousef Hindi | Hospitalist | Wellstar Medical Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Manu Malepati | Hospitalist | Wellstar Medical Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Henry C Nygren | Emergency Medicine | The Bortolazzo Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Sonya D Thompson | Obstetrics/gynecology | Wellstar Medical Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Gray Ndive Akoegbe | Cardiovascular Disease (cardiology) | Wellstar Medical Group, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Morgan T Maeger | Certified Registered Nurse Anesthetist (crna) | Mak Anesthesia Holdings, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Whitney A Wright | Anesthesiology Assistant | Mak Anesthesia Holdings, LLC | 3950 Austell Rd, Austell, GA 30106-1121 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kristian Stodghill | Hospice/palliative Care | Wellstar Medical Group, LLC | 4040 Hospital W Dr, Austell, GA 30106 |
| Warren Todd Oberle | Urology | Georgia Urology, Pa | 1700 Hospital Dr, Suite 201, Austell, GA 30106 |
| Bennie Dean Mobley | Optometry | 3999 Austell Rd, Austell, GA 30106-1100 | |
| James V Waldron | Physician Assistant | Piedmont Providers LLC | 3820 Medical Park Dr, Austell, GA 30106-1110 |
| Karen J Moore | Certified Registered Nurse Anesthetist (crna) | Mulkey Anesthesiology Associates, PC | 3870 Medical Park Dr, Austell, GA 30106-1110 |
| Ashley W Crocker | Certified Registered Nurse Anesthetist (crna) | Mulkey Anesthesiology Associates, PC | 3870 Medical Park Dr, Suite 100, Austell, GA 30106-1110 |
| Omar Hajmurad | Anesthesiology | Interventional Spine and Pain Management Center, PC | 3870 Medical Park Dr, Austell, GA 30106-1110 |
| Megan Rutherford | Physician Assistant | Piedmont Providers LLC | 3820 Medical Park Dr, Austell, GA 30106-1110 |
| Tayler Alyse Walker | Certified Registered Nurse Anesthetist (crna) | Mulkey Anesthesiology Associates, PC | 3870 Medical Park Dr, Austell, GA 30106-1110 |
| Melanie D Marshall | Certified Registered Nurse Anesthetist (crna) | Mulkey Anesthesiology Associates, PC | 3870 Medical Park Dr, Austell, GA 30106-1110 |
| Find all physicians in zip 30106 | |||
| City | AUSTELL |
| Zip Code | 30106 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | AUSTELL + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Thomas C Crouch.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.