Individual provider Active NPI

Michael L Adix, DO

  • Internal Medicine Physician
  • Shelby, NC
National Provider Identifier
1790709111
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9401112 Issued in NC
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, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
8910156MedicaidNC
N01112MedicaidSC

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

OrganizationSpecialtyStatusNew patients
Hannibal Regional Healthcare System Inc Past Accepting new patients
Emcare Physician Providers, Inc. Emergency Medicine Past Accepting new patients
Pinnacle Healthcare Resources PastSince Jun 30, 1994 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602
  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.