Adam David Thompson, PA-C
Individual provider Active NPI Physician Assistant · Carolina Shores, NC
NPI 1447465950 · NPPES record last updated Oct 25, 2020
Key facts
- NPI
- 1447465950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0010-00874 (NC)
- Practice address
- 75 Emerson Bay Rd Ste 102
Carolina Shores, NC 28467-2498 - Phone
- (910) 579-8363
- Fax
- (910) 575-3926
- NPI assigned
- May 10, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-00874 | NC | MD | Physician Assistant |
| 001000874 | NC | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Seaside Family Medicine P.a. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 001000874 | NC | |
| Physician Assistant | 363A00000X | 0010-00874 | NC | Yes |
Addresses
Primary practice location
75 Emerson Bay Rd Ste 102
Carolina Shores, NC 28467-2498
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Phone (910) 575-3923
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447465950 | Medicaid | NC |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | athompson195291@direct.novanthealth.org |
Other providers in Carolina Shores, NC
- Maria Rivell
- Alecia B Roberts
- Charlotte Lee Roberts
- Candice M Sieben
- Stateline Wellness Transport LLC
- Paul C. Whitesides Jr.
- Barbara Annette Wickham
- Natalie Yount
All providers in Carolina Shores, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.