Active NPI
Thomas E Coe, PAC
- Medical Physician Assistant
- Tabor City, NC
National Provider Identifier
1497970545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 100190
- Practice address
- 909 Pireway Road
Tabor City, NC 28463-8942 - Phone
- (910) 653-2112
- Fax
- (910) 653-2346
- NPI assigned
- Apr 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 100190 | NC | Primary |
| Medical Physician Assistant | 363AM0700X | PA103 | SC |
Addresses
Primary practice location
909 Pireway Road
Tabor City, NC 28463-8942
Mailing address
3439 Casey Street
Loris, SC 29569-2903
Phone (843) 756-5300
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02787 | Other | NC | BCBS |
| 5950653 | Medicaid | NC | |
| E03PA0 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA103 | SC | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tabor City Family Medicine Center, Inc. | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- Tabor City, NC
- NPI 1447251103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266451200000",
"number": "1497970545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3439 CASEY STREET",
"city": "LORIS",
"state": "SC",
"postal_code": "295692903",
"telephone_number": "843-756-5300",
"fax_number": "843-756-6059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 PIREWAY ROAD",
"city": "TABOR CITY",
"state": "NC",
"postal_code": "284638942",
"telephone_number": "910-653-2112",
"fax_number": "910-653-2346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COE",
"first_name": "THOMAS",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-16",
"last_updated": "2010-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NC",
"license": "100190",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "SC",
"license": "PA103",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "02787",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5950653",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "E03PA0",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tabor City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.