Individual provider Active NPI

Thomas G. MC Loughlin Jr., M.D.

  • Pediatrics Physician
  • New Smyrna Beach, FL
National Provider Identifier
1144266099
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME79808 Issued in FL
Practice address
1115 S Dixie Fwy
New Smyrna Beach, FL 32168-7473
Phone
(386) 463-5323
NPI assigned
Jun 21, 2006
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME79808 FL Primary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X ME79808 FL

Addresses

Primary practice location

1115 S Dixie Fwy
New Smyrna Beach, FL 32168-7473

Mailing address

4516 Katy Dr
New Smyrna Beach, FL 32169-4112
Phone (386) 679-4458

Other identifiers 2

IdentifierTypeStateIssuer
49725OtherFLBLUE SHIELD OF FL
258515400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20060503000450 FL Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 7012927155 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME79808FLMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quotient Neuro Services LLC Pediatrics CurrentSince Apr 28, 2024 Accepting new patients
Halifax Healthcare Systems Inc CurrentSince Mar 19, 2016 Accepting new patients
Children's Medical Center of Ormond Beach Past Accepting new patients
Emergency Medicine of Florida, Inc. Past Accepting new patients
Halifax Healthcare Systems Inc Past Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

303 N Clyde Morris Blvd
Fl 10
Daytona Beach, FL 32114
Phone (386) 425-2360

1115 S Dixie Fwy
New Smyrna Beach, FL 32168
Phone (386) 463-5323

Use Ci1660
Orlando, FL 32886

740 Dunlawton Ave
Ste 100
Port Orange, FL 32127
Phone (386) 767-2402

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1144266099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4516 KATY DR",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321694112",
            "telephone_number": "386-679-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S DIXIE FWY",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687473",
            "telephone_number": "386-463-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MC LOUGHLIN",
        "first_name": "THOMAS",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME79808",
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME79808",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF FL",
            "identifier": "49725",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258515400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

Verify at the official NPI Registry.