Thaddeus Cox Carter, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

08995 Issued in MS

Practice address

1340 Broad Ave
Suite 210
Gulfport, MS 39501-2418

Phone

(228) 863-4490

Fax

(228) 863-7238

NPI assigned

Jul 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Memorial Hospital at Gulfport

  • General Acute Care Hospital
  • Gulfport, MS
  • NPI 1073606901
  NPD (past)

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1649278573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395021810",
            "telephone_number": "228-863-4490",
            "fax_number": "228-863-7238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 BROAD AVE",
            "address_2": "SUITE 210",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012418",
            "telephone_number": "228-863-4490",
            "fax_number": "228-863-7238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "THADDEUS",
        "middle_name": "COX",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "08995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00019775",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine Marie Carter, M.D.
• Marlana Angel Carter
• Sabrina Carter
• Sonya Lynn Carter, B.S.
• Stacey Ritter Carter, D.M.D.
• Cas Enterprises and Cattle, LLC
• Caspoint Care Inc.
• Hailey Gabrielle Castillon, M.S.,CCC-SLP
• Ellen Dauterive Caswell, MD
• Jason W Caswell, PA

• Specialist in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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.