Individual provider Active NPI

Thomas Arthur Edgerton, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Pinehurst, NC
National Provider Identifier
1124012091
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
15798 Issued in SC
Practice address
155 Memorial Dr
Pinehurst, NC 28374-8710
Phone
(910) 715-4111
Fax
(910) 715-4101
NPI assigned
Sep 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 15798 SC Primary

Addresses

Primary practice location

155 Memorial Dr
Pinehurst, NC 28374-8710

Mailing address

PO Box 843257
Boston, MA 02284-3257
Phone (910) 715-4111

Other identifiers 2

IdentifierTypeStateIssuer
P00344747OtherRAILROAD MEDICARE
N26227MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15798SCMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Piedmont Cardiothoracic Surgery LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Firsthealth of the Carolinas, Inc Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1124012091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843257",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022843257",
            "telephone_number": "910-715-4111",
            "fax_number": "910-715-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MEMORIAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748710",
            "telephone_number": "910-715-4111",
            "fax_number": "910-715-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDGERTON",
        "first_name": "THOMAS",
        "middle_name": "ARTHUR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "SC",
            "license": "15798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00344747",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N26227",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.