Individual provider Active NPI

Thomas W Dickinson, MD

  • Family Medicine Physician
  • Florence, SC
National Provider Identifier
1811960917
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12822 Issued in SC
Practice address
3015 W Palmetto St
Florence, SC 29501-5935
Phone
(843) 777-6870
Fax
(843) 777-7687
NPI assigned
Feb 9, 2006
Last updated
Feb 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 12822 SC Primary

Addresses

Primary practice location

3015 W Palmetto St
Florence, SC 29501-5935

Mailing address

PO Box 3239
Florence, SC 29502-3239
Phone (843) 391-2011

Other identifiers 1

IdentifierTypeStateIssuer
128221MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address thomas.dickinson@mpaii.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061219000157 SC Practitioner - Family Practice 7911906078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical University of South Carolina College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

3015 W Palmetto St
Florence, SC 29501-5935
Phone (843) 777-6870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12822SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Physician Associates II Family Medicine CurrentSince Oct 1, 2006 Accepting new patients
McLeod Physician Associates II CurrentSince Oct 1, 2006 Accepting new patients

Locations

701 Cashua Ferry Rd
Darlington, SC 29532
Phone (843) 395-1100

3015 W Palmetto St
Florence, SC 29501
Phone (843) 777-6870

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

Interoperability endpoints

  • Direct secure messaging: thomas.dickinson.1@18007.direct.athenahealth.com

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1811960917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3239",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295023239",
            "telephone_number": "843-391-2011",
            "fax_number": "843-391-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 W PALMETTO ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295015935",
            "telephone_number": "843-777-6870",
            "fax_number": "843-777-7687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKINSON",
        "first_name": "THOMAS",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "12822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128221",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thomas.dickinson@mpaii.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "ECW DA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "3015 W Palmetto St",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295015935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.