Tsimmeng Justin Thao, DO

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

License

2019-02393 Issued in NC

Practice address

201 E Grover St
Shelby, NC 28150-3917

Phone

(704) 512-5124

NPI assigned

Mar 16, 2016

Last updated

Jul 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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

Specialty

Hospice/Palliative CareAlso: Internal Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atrium Health Cleveland Hospital, Shelby, NC, CCN 340021
• Atrium Health Lincoln Hospital, Lincolnton, NC, CCN 340145
• Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

Merit-based Incentive Payment System (MIPS)

Final score

94 of 100Reported as apm

Quality

81.63

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tthao499712@carolinashealthcaresystem.direct-ci.com

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.

• Carolinas Physicians Network Inc

  dba The Sanger Clinic

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Charlotte, NC
  • NPI 1477878890
  Medicare reassignment Care Compare group NPD
• Carolinas Physicians Network Inc

  dba Atrium Health Diabetes Prevention

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• Carolinas Physicians Network Inc

  dba Carolinas Palliative Care and Hospice Group

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Shelby, NC
  • NPI 1730519182
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Atrium Health Hospitals Inc

  dba Atrium Health Cleveland

  • General Acute Care Hospital
  • Shelby, NC
  • NPI 1669348991
  Care Compare affiliation
• Atrium Health Hospitals Inc

  dba Atrium Health Lincoln

  • General Acute Care Hospital
  • Lincolnton, NC
  • NPI 1730055054
  Care Compare affiliation
• Carolinas Medical Center

  dba Atrium Health Behavioral Health

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1053358945
  Care Compare affiliation
• Carolinas Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1295789907
  Care Compare affiliation
• Carolinas Medical Center

  dba Atrium Health Mercy

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1376985135
  Care Compare affiliation
• Carolinas Medical Center

  dba Levine Children's Hospital Pediatrics

  • Children's Rehabilitation Hospital
  • Charlotte, NC
  • NPI 1699829887
  Care Compare affiliation
• Carolinas Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1720029705

  Hospital

  Care Compare affiliation
• Carolinas Medical Center

  dba Atrium Health Laboratory

  • Clinical Medical Laboratory
  • Charlotte, NC
  • NPI 1811005150

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1487015616",
    "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": "201 E GROVER ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503917",
            "telephone_number": "704-512-5124"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Yadkin St",
            "address_purpose": "LOCATION",
            "city": "Albemarle",
            "state": "NC",
            "postal_code": "280013441",
            "country_code": "US",
            "telephone_number": "704-984-4365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-351-3791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 Vail Ave",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071248",
            "country_code": "US",
            "telephone_number": "704-607-3249",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10628 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108407",
            "country_code": "US",
            "telephone_number": "704-351-9422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAO",
        "first_name": "TSIMMENG",
        "middle_name": "JUSTIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-16",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2019-02393",
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NC",
            "license": "2019-02393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tthao499712@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "201 E Grover St",
            "city": "Shelby",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281503917",
            "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": []
}

• Rebecca Marie Taylor, LPA
• TD Care Home
• Terry Te, M. ED. CCC-SLP
• Julia Tedder, CNS
• Lane Cassidy Tesseneer, LCSW
• The Avalib Care Cart, PLLC
• The Charlotte-Mecklenburg Hospital Authority (Atrium Health Cleveland)
• The Charlotte-Mecklenburg Hospital Authority (Atrium Health Cleveland)
• The Charlotte-Mecklenburg Hospital Authority (Cleveland Pines)
• The Charlotte-Mecklenburg Hospital Authority (Levine Cancer Institute)

• Hospice and Palliative Medicine (Internal Medicine) Physician in Shelby, NC
• Providers in Shelby, NC by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.