Individual provider Active NPI

Charles Thomas Hopkins III, DMD

  • Dentist
  • St Simons Island, GA
National Provider Identifier
1811330301
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN014669 Issued in GA
Practice address
300 Main St Ste 101
Saint Simons Island, GA 31522-1666
Phone
(770) 468-4685
Fax
(912) 634-9819
NPI assigned
Apr 15, 2013
Last updated
Jul 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X DN014669 GA Primary

Addresses

Primary practice location

300 Main St Ste 101
Saint Simons Island, GA 31522-1666

Mailing address

300 Main St Ste 101
Saint Simons Island, GA 31522-1666
Phone (770) 468-4685

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160811000423 GA Order and Referring Only - Other (Non-Physician) 6800180001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN014669GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Hopkins Family Dentistry LLC Dentist CurrentSince Jul 31, 2022 Accepting new patients
Plantation Dental Associates PastSince Jul 31, 2022 Accepting new patients

Locations

300 Main St
Ste 101
St Simons Island, GA 31522
Phone (912) 638-9001

Organizations & group practices 2

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": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1811330301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MAIN ST STE 101",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315221666",
            "telephone_number": "770-468-4685",
            "fax_number": "912-634-9819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MAIN ST STE 101",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315221666",
            "telephone_number": "770-468-4685",
            "fax_number": "912-634-9819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPKINS",
        "first_name": "CHARLES",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-15",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Simons Island, GA

Sources for this page

Verify at the official NPI Registry.