NPIMap

Individual provider Active NPI

Charles Edwin Thomas, M.D.

  • Nephrology Physician
  • Montgomery, AL
National Provider Identifier
1205916590
Registry record updated Jul 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
11300 Issued in AL
Practice address
2034 Chestnut St
Montgomery, AL 36106-1111
Phone
(334) 269-0212
Fax
(334) 269-2144
NPI assigned
Oct 17, 2006
Last updated
Jul 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11300 AL
Nephrology Physician 207RN0300X 11300 AL Primary

Addresses

Primary practice location

2034 Chestnut St
Montgomery, AL 36106-1111

Mailing address

2034 Chestnut St
Montgomery, AL 36106-1111
Phone (334) 269-0212

Other identifiers 1

IdentifierTypeStateIssuer
TH000086803MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040421000507 AL Practitioner - Emergency MedicinePractitioner - Internal Medicine 4587650130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Internal Medicine
Education
University of Alabama School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montgomery Kidney Specialists LLPGroup PAC ID 0345220224, 10 clinicians

Practice addresses (Care Compare)

1548 Professional Pkwy
Auburn, AL 36830-2857
Phone (334) 269-0212

1815 Glynwood Dr
Prattville, AL 36066-5584
Phone (334) 595-6335

2034 Chestnut St
Montgomery, AL 36106-1111
Phone (334) 269-0212

2340 Pepperell Pkwy
Opelika, AL 36801-6240
Phone (334) 745-6883

350 Paul Stabler Dr
Greenville, AL 36037-3128
Phone (334) 383-0006

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11300ALMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery Kidney Specialists, LLP CurrentSince Aug 1, 2008 Accepting new patients
Paragon Contracting Services LLC Past Accepting new patients
Clanton Emergency Physicians, LLC Past Accepting new patients

Locations

1548 Professional Pkwy
Auburn, AL 36830
Phone (334) 826-2901

2034 Chestnut St
Montgomery, AL 36106
Phone (205) 269-0212

Interoperability endpoints

  • Direct secure messaging: charles.thomas@direct.davitaphysiciansolutions.com

Organizations & group practices 3

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 7

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216944000000",
    "number": "1205916590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2034 CHESTNUT ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061111",
            "telephone_number": "334-269-0212",
            "fax_number": "334-269-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2034 CHESTNUT ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061111",
            "telephone_number": "334-269-0212",
            "fax_number": "334-269-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CHARLES",
        "middle_name": "EDWIN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "11300",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AL",
            "license": "11300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH000086803",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.