Organization Active NPI

Thomas J. Antalik, MD

  • Surgery Physician
  • Roxboro, NC
National Provider Identifier
1639358195
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
THOMAS J. ANTALIK, MD
Practice address
511 Ridge Rd
Roxboro, NC 27573-4627
Phone
(336) 597-5462
Fax
(336) 597-9428
NPI assigned
Oct 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Authorized official

Name
Trent O Shelton
Title
Billing
Phone
(919) 544-6318

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

511 Ridge Rd
Roxboro, NC 27573-4627

Mailing address

PO Box 3193
Durham, NC 27715-3193
Phone (919) 544-6318

National Provider Directory

National Provider Directory

Locations

511 Ridge Rd
Roxboro, NC 27573
Phone (336) 597-5462

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1639358195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3193",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277153193",
            "telephone_number": "919-544-6318",
            "fax_number": "919-544-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 RIDGE RD",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275734627",
            "telephone_number": "336-597-5462",
            "fax_number": "336-597-9428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS J. ANTALIK, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "SHELTON",
        "authorized_official_first_name": "TRENT",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "919-544-6318"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.