Individual provider Active NPI

Charles Murry Thompson, MD

  • Adolescent Medicine (Family Medicine) Physician
  • Mt Pleasant, SC
National Provider Identifier
1528089240
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent Medicine (Family Medicine) PhysicianTaxonomy code 207QA0000X
License
207QA0000X Issued in SC
Practice address
900 Bowman Rd
Suite 304
Mt Pleasant, SC 29464-3203
Phone
(843) 884-1217
Fax
(843) 884-7796
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Family Medicine) Physician 207QA0000X 207QA0000X SC Primary

Addresses

Primary practice location

900 Bowman Rd
Suite 304
Mt Pleasant, SC 29464-3203

Mailing address

900 Bowman Rd
Suite 304
Mt Pleasant, SC 29464-3203
Phone (843) 884-1217

Other identifiers 1

IdentifierTypeStateIssuer
10744OtherSCMEDICAL LICENSE

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
207QA0000XSCMDAdolescent Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adolescent Medicine Associates Adolescent Medicine 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.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528089240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 BOWMAN RD",
            "address_2": "SUITE 304",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643203",
            "telephone_number": "843-884-1217",
            "fax_number": "843-884-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 BOWMAN RD",
            "address_2": "SUITE 304",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643203",
            "telephone_number": "843-884-1217",
            "fax_number": "843-884-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "CHARLES",
        "middle_name": "MURRY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0000X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": "SC",
            "license": "207QA0000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "10744",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.