Kenneth Arthur Thompson, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2020-02536 Issued in NC

Practice address

5010 Carolina Forest Blvd
Myrtle Beach, SC 29579-3579

Phone

(843) 903-1010

Fax

(843) 903-1015

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in NC, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kthompson80000@capefearvalley.direct-ci.com
• Direct secure messaging: kthompson51138@directmcleodehealth.org

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.

• DLP Central Carolina Medical Group LLC

  • Urology Physician
  • Sanford, NC
  • NPI 1184163883
  Medicare reassignment NPD
• Quentin N Burdick Comprehensive Health Care Facility

  • Rural Acute Care Hospital
  • Belcourt, ND
  • NPI 1952346934

  TX

  Medicare reassignment NPD
• DLP Central Carolina Medical Group LLC

  • Surgery Physician
  • Sanford, NC
  • NPI 1205375953
  NPD
• DLP Central Carolina Medical Group LLC

  • Rural Health Clinic/Center
  • Broadway, NC
  • NPI 1578254215
  NPD
• Marlboro Clinic Corp

  • Obstetrics & Gynecology Physician
  • Bennettsville, SC
  • NPI 1043219637
  NPD (past)
• Marlboro Clinic Corp

  • Obstetrics & Gynecology Physician
  • Bennettsville, SC
  • NPI 1275692501
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1669489100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-5139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 CAROLINA FOREST BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793579",
            "telephone_number": "843-903-1010",
            "fax_number": "843-903-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KENNETH",
        "middle_name": "ARTHUR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "1032",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2020-02536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "000000204502",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "408253",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4505",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00689014",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0165925",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010321",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5502655",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905507",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Thomas
• Ellie Thompson, PHARM.D.
• Frances Lindsay Thompson, PSYD
• Joel R Thompson, MD
• Karen Thompson, APRN WHNP
• Sheliza Thompson, LPCA
• James K Thornton, DMD
• Thomas Justin Thornton, DO
• Thrasher Psychotherapeutics PA
• Thrive Chiropractic and Wellness Center

• Obstetrics & Gynecology Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Obstetrics & Gynecology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.