NPIMap

Individual provider Active NPI

Maria Carmen Thomae, N.P.

  • Women's Health Nurse Practitioner
  • Charleston, SC
National Provider Identifier
1548358781
Registry record updated Jan 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
21112 Issued in SC
Practice address
171 Ashley Ave
Charleston, SC 29425-6484
Phone
(843) 792-1414
NPI assigned
Oct 11, 2006
Last updated
Jan 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN135792 GA
Women's Health Nurse Practitioner 363LW0102X 21112 SC Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-6484

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

Other practice location 1

2806 Hillcreek Dr
Augusta, GA 30909-6484
Phone (706) 863-0200 ext. 128

Other identifiers 2

IdentifierTypeStateIssuer
000875212CMedicaidGA
NP0855MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC, VA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040802001611 GA Practitioner - Nurse Practitioner 6002887205
I20180208002007 SC Practitioner - Nurse Practitioner 6002887205 Reassigns benefits to 1 organization
I20260130000461 VA Practitioner - Nurse Practitioner 6002887205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

1744 Sir William Osler Dr
Virginia Beach, VA 23454-3003
Phone (757) 481-4036

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN135792GAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Jan 8, 2026 Accepting new patients
University Medical Associates of the Medical University of South Carol Current Accepting new patients
Unified Women's Care of Georgia, LLC CurrentSince Dec 10, 2013 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jan 11, 2018 Accepting new patients
Privia Medical Group, LLC CurrentSince Jan 8, 2026 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jan 11, 2018 Accepting new patients
Wellstar Medical Group, LLC Past Accepting new patients
Pulmonologists, PC Past Accepting new patients
Wellstar Northwest Women's Care, LLC Past Accepting new patients

Locations

2806 Hillcreek Dr
Augusta, GA 30909
Phone (706) 863-0200

980 Johnson Fy Rd NE
Ste 720
Sandy Springs, GA 30342
Phone (404) 252-3898

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

8644 Sudley Rd
#220
Manassas, VA 20110

1744 Sir William Osler Dr
Virginia Beach, VA 23454
Phone (757) 481-4036

Organizations & group practices 9

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516233600000",
    "number": "1548358781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294256484",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2806 Hillcreek Dr",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309096484",
            "country_code": "US",
            "telephone_number": "706-863-0200 x128",
            "fax_number": "706-863-4695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAE",
        "first_name": "MARIA",
        "middle_name": "CARMEN",
        "name_prefix": "Ms.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2018-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN135792",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "SC",
            "license": "21112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000875212C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0855",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.