Individual provider Active NPI

Thomas E Payne, NP

  • Nurse Practitioner
  • Mount Airy, NC
National Provider Identifier
1316907579
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Practice address
865 W Lake Dr
Mt Airy, NC 27030-2157
Phone
(336) 719-6100
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NC Primary

Addresses

Primary practice location

865 W Lake Dr
Mt Airy, NC 27030-2157

Mailing address

2000 Frontis Plaza Blvd Ste 200
Attn Forsyth Medical Group
Winston Salem, NC 27103-5616
Phone (336) 277-2436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051202000474 NC Practitioner - Nurse Practitioner 2365462579 Reassigns benefits to 2 organizations
I20200526003010 GA Practitioner - Nurse Practitioner 2365462579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
005001025NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Phoebe Physician Group, Inc CurrentSince Apr 1, 2020 Accepting new patients
Phoebe Infectious Disease CurrentSince Apr 1, 2020 Accepting new patients
Wake Forest University Health Sciences CurrentSince Aug 27, 2016 Accepting new patients
Grace Clinic of Yadkin Valley CurrentSince Jul 24, 2019 Accepting new patients

Locations

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

2000 Palmyra Rd
Albany, GA 31701
Phone (229) 434-2000

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900

948 Johnson Ridge Rd
Elkin, NC 28621
Phone (336) 835-1467

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1721/brand/1/csg/1/fhir/r4
  • Direct secure messaging: thomas.payne.1@1721.direct.athenahealth.com
  • Direct secure messaging: tpayne2753294@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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 5

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316907579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 FRONTIS PLAZA BLVD STE 200",
            "address_2": "ATTN FORSYTH MEDICAL GROUP",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035616",
            "telephone_number": "336-277-2436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 W LAKE DR",
            "city": "MT AIRY",
            "state": "NC",
            "postal_code": "270302157",
            "telephone_number": "336-719-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "THOMAS",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, NC

Sources for this page

Verify at the official NPI Registry.