Individual provider Active NPI

Tyler Shane Thread, NP

  • Nurse Practitioner
  • Monroe, NC
National Provider Identifier
1801673389
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5018943 Issued in NC
Practice address
1550 Faulk St
Ste 3100
Monroe, NC 28112-5086
Phone
(704) 667-3410
NPI assigned
Sep 11, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5018943 NC
Gerontology Nurse Practitioner 363LG0600X 5018943 NC
Nurse Practitioner 363L00000X 5018943 NC Primary

Addresses

Primary practice location

1550 Faulk St
Ste 3100
Monroe, NC 28112-5086

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

101 E W T Harris Blvd
Ste 1213
Charlotte, NC 28262-3485
Phone (704) 863-1950

Other practice location 2

134 Medical Park Rd
Ste 111 - Adult Cardiology
Mooresville, NC 28117-8526
Phone (704) 801-9100

Other practice location 3

1237 Harding Pl
Ste 3100
Charlotte, NC 28204
Phone (704) 373-0212

Other practice location 4

447 McAlister Rd
Ste 3200
Lincolnton, NC 28092-4114
Phone (980) 212-6300

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tthread361911@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231201002437 NC Practitioner - Nurse Practitioner 6709234628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

100 Medical Park Dr
Suite 210
Concord, NC 28025-2966
Phone (704) 403-6100

Hospital & facility affiliations

  • Atrium Health Union Hospital, Monroe, NC, CCN 340130
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5018943NCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Dec 18, 2023 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 18, 2023 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1237 Harding Pl
Ste 3100
Charlotte, NC 28204

101 E Wt Harris Blvd
Ste 1213
Charlotte, NC 28262
Phone (704) 863-1950

100 Medical Park Dr
Ste 210
Concord, NC 28025
Phone (704) 403-6100

990 Lee Ann Dr NE
Concord, NC 28025
Phone (704) 441-0272

447 McAlister Rd
Ste 3200
Lincolnton, NC 28092
Phone (980) 212-6300

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

1550 Faulk St
Ste 3100
Monroe, NC 28112
Phone (704) 667-3410

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

Interoperability endpoints

  • Direct secure messaging: tthread361911@carolinashealthcaresystem.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1694390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1801673389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 FAULK ST",
            "address_2": "STE 3100",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281125086",
            "telephone_number": "704-667-3410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E W T Harris Blvd",
            "address_2": "Ste 1213",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623485",
            "country_code": "US",
            "telephone_number": "704-863-1950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "134 Medical Park Rd",
            "address_2": "Ste 111 - Adult Cardiology",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281178526",
            "country_code": "US",
            "telephone_number": "704-801-9100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 3100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28204",
            "country_code": "US",
            "telephone_number": "704-373-0212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "447 McAlister Rd",
            "address_2": "STE 3200",
            "address_purpose": "LOCATION",
            "city": "Lincolnton",
            "state": "NC",
            "postal_code": "280924114",
            "country_code": "US",
            "telephone_number": "980-212-6300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THREAD",
        "first_name": "TYLER",
        "middle_name": "SHANE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-11",
        "last_updated": "2024-07-24",
        "certification_date": "2023-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5018943",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5018943",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5018943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tthread361911@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1550 Faulk St",
            "address_2": "Ste 3100",
            "city": "Monroe",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281125086",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

Verify at the official NPI Registry.