Individual provider Active NPI

Micah Thomas, DO

  • Emergency Medicine Physician
  • Myrtle Beach, SC
National Provider Identifier
1114421252
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
28755 Issued in MS
Practice address
809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone
(843) 692-1752
Fax
(843) 692-1904
NPI assigned
Mar 22, 2018
Last updated
May 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X 28755 MS Primary

Addresses

Primary practice location

809 82ND Pkwy
Myrtle Beach, SC 29572-4607

Mailing address

504 Glendalyn Ave
Spartanburg, SC 29302-2011
Phone (901) 826-0806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, MS, TN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210218000509 SC Practitioner - Emergency Medicine 6709139835 Reassigns benefits to 1 organization
I20210519002471 MS Practitioner - Emergency Medicine 6709139835 Reassigns benefits to 4 organizations
I20210830001865 TN Practitioner - Emergency Medicine 6709139835 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mississippi Emergency Department Services PCGroup PAC ID 7113453960, 40 clinicians

Practice addresses (Care Compare)

2809 Denny Ave
Pascagoula, MS 39581-5301
Phone (228) 809-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28755MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Cheraw CurrentSince Jan 28, 2021 Accepting new patients
Methodist University Emergency Physicians PLLC Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
Emergency Room Group LTD Emergency Medicine CurrentSince Jun 14, 2023 Accepting new patients
McLeod Health Cheraw Emergency Medicine CurrentSince Jan 28, 2021 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Jul 1, 2021 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Aug 1, 2021 Accepting new patients
Germantown Emergency Physicians, PLLC Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
Methodist South Emergency Physicians, PLLC Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
Olive Branch Emergency Physicians LLC Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
Methodist North Emergency Physicians, PLLC Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
Mississippi Emergency Department Services PC Emergency Medicine CurrentSince Nov 26, 2024 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients

Locations

15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000

3109 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 818-1100

4250 Bethel Rd
Olive Branch, MS 38654
Phone (662) 932-9000

2809 Denny Ave
Pascagoula, MS 39581
Phone (228) 809-5000

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

1500 W Poplar Ave
Collierville, TN 38017
Phone (901) 227-8140

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

1300 Wesley Dr
Memphis, TN 38116
Phone (901) 516-3700

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1114421252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 GLENDALYN AVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293022011",
            "telephone_number": "901-826-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724607",
            "telephone_number": "843-692-1752",
            "fax_number": "843-692-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MICAH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-22",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "28755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.