Individual provider Active NPI

Michael K Tomlin, MD

  • Anesthesiology Physician
  • Charleston, SC
National Provider Identifier
1780631614
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
17570 Issued in SC
Practice address
125 Doughty St
Ste 420
Charleston, SC 29403
Phone
(843) 723-3441
Fax
(843) 805-4040
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 17570 SC Primary

Addresses

Primary practice location

125 Doughty St
Ste 420
Charleston, SC 29403

Mailing address

PO Box 22206
Charleston, SC 29403-2206
Phone (843) 723-3441

Other practice location 1

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1436

Other identifiers 1

IdentifierTypeStateIssuer
175704MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060823000366 SC Practitioner - Anesthesiology 1456354935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Alabama School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates of Charleston PAGroup PAC ID 4082607361, 38 clinicians

Practice addresses (Care Compare)

1064 Gardner Rd
Suite 112
Charleston, SC 29407-5768
Phone 8437233441551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17570SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Charleston, P.a. Anesthesiology CurrentSince Jul 1, 2003 Accepting new patients
Anesthesia Services of Charleston Anesthesiology CurrentSince Jul 1, 2013 Accepting new patients
Donald S. Kilpatrick, M.D.,P.a. Anesthesiology Past Accepting new patients
Scca, LLC Anesthesiology Past Accepting new patients
Anesthesia Associates of Charleston, P.a. PastSince Jun 21, 2020 Accepting new patients

Locations

1064 Gardner Rd
Ste 112
Charleston, SC 29407
Phone (843) 723-3441

1849 Savage Rd
Charleston, SC 29407
Phone (843) 576-2600

125 Doughty St
Ste 420
Charleston, SC 29403
Phone (843) 723-3441

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1780631614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22206",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294032206",
            "telephone_number": "843-723-3441",
            "fax_number": "843-805-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 DOUGHTY ST",
            "address_2": "STE 420",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29403",
            "telephone_number": "843-723-3441",
            "fax_number": "843-805-4040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2095 Henry Tecklenburg Dr",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294145733",
            "country_code": "US",
            "telephone_number": "843-402-1436",
            "fax_number": "843-402-1833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOMLIN",
        "first_name": "MICHAEL",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "17570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175704",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.