Individual provider Active NPI

Thomas E. Brewington Jr., M.D.

  • Ophthalmology Physician
  • Greensboro, NC
National Provider Identifier
1629055934
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
17620 Issued in NC
Practice address
807 Summit Ave
Greensboro, NC 27405-7833
Phone
(336) 272-5628
Fax
(336) 273-1671
NPI assigned
Dec 28, 2005
Last updated
Dec 14, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 17620 NC Primary

Addresses

Primary practice location

807 Summit Ave
Greensboro, NC 27405-7833

Mailing address

807 Summit Ave
Greensboro, NC 27405-7833
Phone (336) 272-5628

Other identifiers 3

IdentifierTypeStateIssuer
0628160001OtherNCDMERC
8918237MedicaidNC
18237OtherNCBCBS

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17620NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Ophthalmology Consultants, PLLC Ophthalmology PastSince Feb 16, 2016 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1629055934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 SUMMIT AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274057833",
            "telephone_number": "336-272-5628",
            "fax_number": "336-273-1671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 SUMMIT AVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274057833",
            "telephone_number": "336-272-5628",
            "fax_number": "336-273-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWINGTON",
        "first_name": "THOMAS",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "17620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0628160001",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8918237",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "18237",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; 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.