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ATHENS BEHAVIORAL MEDICINE
NPI 1902026347
Psychiatry & Neurology - Psychiatry in Bogart, GA

Active since April 26, 2007CLIA 11D2350047 · Waiver
1361 JENNINGS MILL RD, STE 201, BOGART, GA 30622(706) 316-1908(706) 316-2062 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Athens Behavioral Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ATHENS BEHAVIORAL MEDICINE (NPI 1902026347) is a healthcare organization registered as a psychiatry in Bogart, Georgia and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through September 1, 2028 and lists Susie Watkins, Billing, as its authorized official.

NPPES Registry Identity

NPI1902026347
Entity TypeOrganization
Primary Taxonomy2084P0800X
Legal Business NameATHENS BEHAVIORAL MEDICINE
Location Address1361 JENNINGS MILL RD, STE 201Bogart, GA 30622-2592
Mailing Address1361 Jennings Mill Rd, Suite 201Bogart, GA 30622-2592 · (706) 316-1908 · Fax (706) 316-2062
Phone(706) 316-1908
Fax(706) 316-2062
Organization SubpartNo
Authorized OfficialSusie WatkinsBilling · (709) 316-1908
Enumeration DateApril 26, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1902026347 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in GA · 051255
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
1361 JENNINGS MILL RD, Bogart, GA 30622
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Other Identifiers 1

Medicaid00958625AGA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Athens Behavioral Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Athens Behavioral Medicine, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Thomas Mccormack, MD
Psychiatry
NPI 1740298728
1361 JENNINGS MILL ROAD BUILDING 200 SUITE 201
Bogart, GA 30622
(706) 316-1908
✔ PECOS✔ Accepts MedicareSame address
Thomas Van Aken, MD
Psychiatry
NPI 1831172139
798 ROUTE 9 STE A
Fishkill, NY 12524
(845) 896-2544
✔ PECOS741 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2350047

Athens Behavioral Medicine · Watkinsville, GA
Active · expires Sep 1, 2028
CLIA Number11D2350047
Laboratory TypePhysician Office
Certificate Effective DateSeptember 2, 2026
Certificate Expiration DateSeptember 1, 2028
Laboratory DirectorThomas W. Mccormack
Laboratory Phone(706) 316-1908
Laboratory LocationAthens Behavioral Medicine1361 Jennings Mill Road, Suite 201, Watkinsville, GA 30677
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Athens Behavioral Medicine's NPI number?

The NPI number for Athens Behavioral Medicine is 1902026347. It was assigned to this organization in the NPPES registry on April 26, 2007.

Where is Athens Behavioral Medicine located?

Athens Behavioral Medicine is located at 1361 Jennings Mill Rd Ste 201, Bogart, GA 30622. The listed phone number is (706) 316-1908.

What is Athens Behavioral Medicine's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Athens Behavioral Medicine enrolled in Medicare?

Yes. Athens Behavioral Medicine is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Athens Behavioral Medicine?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Psychiatry, reassign their Medicare billing to Athens Behavioral Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Athens Behavioral Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2350047) is associated with this NPI, valid through September 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Athens Behavioral Medicine was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.