Individual provider Active NPI

Everette B Thombs Sr., MD

  • Internal Medicine Physician
  • Kings Mountain, NC
National Provider Identifier
1053335281
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25194 Issued in NC
Practice address
711 W Mountain St
Kings Mountain, NC 28086-2711
Phone
(704) 739-9586
Fax
(704) 739-6119
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25194 NC Primary

Addresses

Primary practice location

711 W Mountain St
Kings Mountain, NC 28086-2711

Mailing address

PO Box 801
Kings Mountain, NC 28086-0801
Phone (704) 739-9586

Other identifiers 1

IdentifierTypeStateIssuer
8982776MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20120914000398 NC Practitioner - Internal Medicine 0042468134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Howard University College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

711 W Mountain St
Kings Mountain, NC 28086-2711
Phone (704) 739-9586

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25194NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Everette B Thombs, MD Internal Medicine CurrentSince Apr 29, 1996 Accepting new patients
Charlotte Neurology, PLLC PastSince Apr 29, 1996 Accepting new patients

Locations

107 W King St
Kings Mtn, NC 28086
Phone (704) 739-9587

711 W Mountain St
Kings Mtn, NC 28086
Phone (704) 739-5456

Organizations & group practices 2

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 1

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053335281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280860801",
            "telephone_number": "704-739-9586",
            "fax_number": "704-739-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 W MOUNTAIN ST",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280862711",
            "telephone_number": "704-739-9586",
            "fax_number": "704-739-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMBS",
        "first_name": "EVERETTE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "25194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8982776",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Mountain, NC

Sources for this page

Verify at the official NPI Registry.