Individual provider Active NPI

Thomas M Verdin, MD

  • Pediatrics Physician
  • Calabash, NC
National Provider Identifier
1437102720
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2009-01427 Issued in NC
Practice address
9869 Ocean Hwy W Ste 12
Calabash, NC 28467-2636
Phone
(910) 575-3522
Fax
(910) 575-3580
NPI assigned
May 18, 2006
Last updated
May 10, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5565 SC
Pediatrics Physician 208000000X 2009-01427 NC Primary
Pediatrics Physician 208000000X ME 104768 FL

Addresses

Primary practice location

9869 Ocean Hwy W Ste 12
Calabash, NC 28467-2636

Mailing address

9869 Ocean Hwy W Ste 12
Calabash, NC 28467-2636
Phone (910) 575-3522

Other identifiers 1

IdentifierTypeStateIssuer
FQC024MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20140118000079 NC Practitioner - Pediatric Medicine 3870721996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Medical University of South Carolina College of Medicine, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9869 Ocean Hwy W
Suite 12
Calabash, NC 28467-2636
Phone (910) 575-3522

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 104768FLMDPediatrics Physician
2009-01427NCMDPediatrics Physician

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368144000000",
    "number": "1437102720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9869 OCEAN HWY W STE 12",
            "city": "CALABASH",
            "state": "NC",
            "postal_code": "284672636",
            "telephone_number": "910-575-3522",
            "fax_number": "910-575-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9869 OCEAN HWY W STE 12",
            "city": "CALABASH",
            "state": "NC",
            "postal_code": "284672636",
            "telephone_number": "910-575-3522",
            "fax_number": "910-575-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDIN",
        "first_name": "THOMAS",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2013-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "5565",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2009-01427",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 104768",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FQC024",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabash, NC

Sources for this page

Verify at the official NPI Registry.