Organization Active NPI

Thomas G Pottle MD PC

  • Plastic Surgery Physician
  • Wilmington, NC
National Provider Identifier
1548219967
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
28311 Issued in NC
Legal business name
THOMAS G POTTLE MD PC
Practice address
5305K Wrightville Ave
Wilmington, NC 28403
Phone
(910) 452-2175
Fax
(910) 452-1962
NPI assigned
May 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Thomas Galbraith Pottle, MD
Title
MD Owner
Phone
(910) 452-2175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X 28311 NC Primary

Addresses

Primary practice location

5305K Wrightville Ave
Wilmington, NC 28403

Mailing address

5305K Wrightville Ave
Wilmington, NC 28403
Phone (910) 452-2175

Other identifiers 1

IdentifierTypeStateIssuer
8911878MedicaidNC

National Provider Directory

National Provider Directory

Locations

5305 Wrightsville Ave
Ste K
Wilmington, NC 28403
Phone (910) 452-2175

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548219967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305K WRIGHTVILLE AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28403",
            "telephone_number": "910-452-2175",
            "fax_number": "910-452-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305K WRIGHTVILLE AVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28403",
            "telephone_number": "910-452-2175",
            "fax_number": "910-452-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS G POTTLE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POTTLE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "GALBRAITH",
        "authorized_official_title_or_position": "MD OWNER",
        "authorized_official_telephone_number": "910-452-2175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "28311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8911878",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.