Active NPI
Charles Thomas Hopkins III, DMD
- Dentist
- St Simons Island, GA
National Provider Identifier
1811330301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN014669
- 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, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160811000423 | GA | Order and Referring Only - Other (Non-Physician) | 6800180001 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN014669 | GA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hopkins Family Dentistry LLC | Dentist | Current | Accepting new patients |
| Plantation Dental Associates | Past | 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.
-
- Dentist
- St Simons Island, GA
- NPI 1700286291
-
dba Dr Jack H Melton
- General Practice Dentistry
- St Simons Island, GA
- NPI 1063505113
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.