Individual provider Active NPI

Thomas Canyon Gore, DO

  • Internal Medicine Physician
  • Hudson, FL
National Provider Identifier
1407343981
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4342 Issued in TN
Practice address
14000 Fivay Rd
Hudson, FL 34667-7103
Phone
(727) 819-2966
NPI assigned
Apr 19, 2018
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4342 TN Primary

Addresses

Primary practice location

14000 Fivay Rd
Hudson, FL 34667-7103

Mailing address

14000 Fivay Rd
Hudson, FL 34667-7103
Phone (727) 819-2966

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210708002044 TN Practitioner - Internal Medicine 3375874019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of TN LLCGroup PAC ID 2365807633, 266 clinicians

Practice addresses (Care Compare)

2300 Patterson St
Nashville, TN 37203-1538
Phone (615) 342-1000

2333 McCallie Ave
Chattanooga, TN 37404-3258
Phone (423) 698-6061

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of TN, LLC CurrentSince Apr 1, 2023 Accepting new patients
Parkridge Medical Center, Inc. Past Accepting new patients

Locations

2333 McCallie Ave
Chattanooga, TN 37404
Phone (423) 493-1387

941 Spring Creek Rd
East Ridge, TN 37412
Phone (423) 855-3255

2300 Patterson St
#M
Nashville, TN 37203

Organizations & group practices 2

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 1

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": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1407343981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14000 FIVAY RD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677103",
            "telephone_number": "727-819-2966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14000 FIVAY RD",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346677103",
            "telephone_number": "727-819-2966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "THOMAS",
        "middle_name": "CANYON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "4342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, FL

Sources for this page

Verify at the official NPI Registry.