NPIMap

Individual provider Active NPI

Thomas B. Kelso II, MD

  • Orthopaedic Surgery Physician
  • Southport, NC
National Provider Identifier
1265570469
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
200300626 Issued in NC
Practice address
902 N Howe St
Southport, NC 28461-3038
Phone
(910) 457-4789
Fax
(910) 579-4589
NPI assigned
Feb 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 120032 MO
Orthopaedic Surgery Physician 207X00000X 200300626 NC Primary

Addresses

Primary practice location

902 N Howe St
Southport, NC 28461-3038

Mailing address

902 N Howe St
Southport, NC 28461-3038
Phone (910) 457-4789

Other identifiers 1

IdentifierTypeStateIssuer
204883003MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20100714000924 NC Practitioner - Orthopedic Surgery 5294867032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Maryland School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

120 William Penn PLZ
Durham, NC 27704-2150
Phone (919) 220-5255

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement19
Knee replacement46
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)22

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA Orthopaedic Surgery CurrentSince Jul 1, 2016 Accepting new patients
Emergeortho PA CurrentSince Jul 1, 2016 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

120 William Penn Plz
Durham, NC 27704
Phone (919) 281-1836

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

5160 Ocean Hwy W
Shallotte, NC 28470
Phone (910) 332-3828

902 N Howe St
Southport, NC 28461
Phone (910) 457-4789

2716 Ashton Dr
Wilmington, NC 28412
Phone (910) 332-1534

Interoperability endpoints

  • Direct secure messaging: tkelso199815@direct.novanthealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1265570469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 N HOWE ST",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284613038",
            "telephone_number": "910-457-4789",
            "fax_number": "910-579-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 N HOWE ST",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284613038",
            "telephone_number": "910-457-4789",
            "fax_number": "910-579-4589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSO",
        "first_name": "THOMAS",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "120032",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "200300626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204883003",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

Verify at the official NPI Registry.