Thomas Wilson Vinson, DDS
Individual provider Active NPI General Practice Dentistry · Murfreesboro, NC
NPI 1174556997 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1174556997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 5143 (NC)
- Practice address
- 112 E Broad St
Murfreesboro, NC 27855-1403 - Phone
- (252) 398-5143
- Fax
- (252) 398-4881
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160523001742 | NC | Order and Referring Only - Dentist |
1052600509 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5143 | NC | MD | Certified Registered Nurse Anesthetist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5143 | NC | Yes |
Addresses
Primary practice location
112 E Broad St
Murfreesboro, NC 27855-1403
Mailing address
112 E Broad St
Murfreesboro, NC 27855-1403
Phone (252) 398-5143
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7998775 | Medicaid | NC |
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All providers in Murfreesboro, NC · General Practice Dentistry in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.