Active NPI
Michael L Adix, DO
- Internal Medicine Physician
- Shelby, NC
National Provider Identifier
1790709111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 9401112
- Practice address
- 419 Earl Road
Shelby, NC 28150 - Phone
- (704) 481-0555
- Fax
- (704) 481-9169
- NPI assigned
- Jul 27, 2006
- Last updated
- Dec 11, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 2011040029 | MO | |
| Internal Medicine Physician | 207R00000X | 9401112 | NC | Primary |
Addresses
Primary practice location
419 Earl Road
Shelby, NC 28150
Mailing address
3152 Little Road, Suite 115
Trinity, FL 34655
Phone (727) 510-7536
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8910156 | Medicaid | NC | |
| N01112 | Medicaid | SC |
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 Osteopathy, Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hannibal Regional Healthcare System Inc | Past | Accepting new patients | |
| Emcare Physician Providers, Inc. | Emergency Medicine | Past | Accepting new patients |
| Pinnacle Healthcare Resources | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
- madix24661@surescripts.sfmc.net
Organizations & group practices 3
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.
-
dba Shelby Walk In Medical Center
- Health Service Clinic/Center
- Shelby, NC
- NPI 1962410894
-
- Emergency Medicine Physician
- Columbus, NC
- NPI 1033169792
-
- Multi-Specialty Clinic/Center
- Hannibal, MO
- NPI 1003956095
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607644800000",
"number": "1790709111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3152 LITTLE ROAD, SUITE 115",
"city": "TRINITY",
"state": "FL",
"postal_code": "34655",
"telephone_number": "727-510-7536",
"fax_number": "727-494-7421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 EARL ROAD",
"city": "SHELBY",
"state": "NC",
"postal_code": "28150",
"telephone_number": "704-481-0555",
"fax_number": "704-481-9169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADIX",
"first_name": "MICHAEL",
"middle_name": "L",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2020-12-11",
"certification_date": "2020-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MO",
"license": "2011040029",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NC",
"license": "9401112",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8910156",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N01112",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Shelby, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.