Individual provider Active NPI

Gary A. Thompson, MD

  • Anesthesiology Physician
  • Beaufort, SC
National Provider Identifier
1417921461
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
19229 Issued in SC
Practice address
955 Ribaut Road
Beaufort, SC 29902
Phone
(843) 522-5087
Fax
(843) 522-5007
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 19229 SC Primary
Pain Medicine (Anesthesiology) Physician 207LP2900X 19229 SC
Pain Medicine Physician 208VP0000X 19229 SC

Addresses

Primary practice location

955 Ribaut Road
Beaufort, SC 29902

Mailing address

PO Box 74
Columbia, SC 29202
Phone (803) 454-2613

Other identifiers 1

IdentifierTypeStateIssuer
192295MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20050301000630 SC Practitioner - Anesthesiology 1254316227 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Low Country Anesthesia, PA Anesthesiology CurrentSince Jul 28, 1997 Accepting new patients

Locations

955 Ribaut Rd
#C
Beaufort, SC 29902

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1417921461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29202",
            "telephone_number": "803-454-2613",
            "fax_number": "803-765-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 RIBAUT ROAD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "29902",
            "telephone_number": "843-522-5087",
            "fax_number": "843-522-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "GARY",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "19229",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "SC",
            "license": "19229",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "SC",
            "license": "19229",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192295",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

Verify at the official NPI Registry.