NPIMap

Individual provider Active NPI

Thomas Sanderson Gavigan, MD

  • Surgical Critical Care Physician
  • Charlotte, NC
National Provider Identifier
1407267545
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
2020-02743 Issued in NC
Practice address
1350 S Kings Dr
Charlotte, NC 28207-2134
Phone
(704) 446-1255
NPI assigned
May 12, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2020-02743 NC
Surgical Critical Care Physician 2086S0102X 2020-02743 NC Primary

Addresses

Primary practice location

1350 S Kings Dr
Charlotte, NC 28207-2134

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

200 Medical Park Dr
Ste 430
Concord, NC 28025-2982
Phone (704) 403-7070

Other practice location 2

1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204-2963
Phone (704) 355-1813

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Ambulatory@direct.carolinashealthcare.org Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

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
I20200909001806 NC Practitioner - General Surgery 0143657437 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

2104 Randolph Rd
Charlotte, NC 28207-1522
Phone (704) 344-3900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair (minimally invasive)18
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020-02743NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Aug 10, 2020 Accepting new patients
Carolinas Medical Center Surgical Critical Care CurrentSince Aug 10, 2020 Accepting new patients
Novant Health Medical Group, LLC Surgery CurrentSince Jul 23, 2021 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Physicians Network Inc Surgery CurrentSince Aug 10, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 23, 2021 Accepting new patients
Carolinas Medical Center CurrentSince Aug 10, 2020 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

2104 Randolph Rd
Charlotte, NC 28207
Phone (704) 344-3900

1025 Morehead Medical Dr
Ste 300
Charlotte, NC 28204
Phone (704) 355-1813

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

330 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 316-2350

200 Medical Park Dr
Ste 430
Concord, NC 28025
Phone (704) 403-5890

1450 Matthews Township Pkwy
Ste 230
Matthews, NC 28105
Phone (704) 384-8615

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: tgavigan894322@direct.novanthealth.org
  • Direct secure messaging: ambulatory@direct.carolinashealthcare.org

Organizations & group practices 10

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 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": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1407267545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072134",
            "telephone_number": "704-446-1255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Medical Park Dr",
            "address_2": "Ste 430",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252982",
            "country_code": "US",
            "telephone_number": "704-403-7070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1025 Morehead Medical Dr",
            "address_2": "Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282042963",
            "country_code": "US",
            "telephone_number": "704-355-1813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAVIGAN",
        "first_name": "THOMAS",
        "middle_name": "SANDERSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-12",
        "last_updated": "2023-05-04",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2020-02743",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "NC",
            "license": "2020-02743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ambulatory@direct.carolinashealthcare.org",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1350 S Kings Dr",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282072134",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.