Individual provider Active NPI

Cecil Koshey Thoppil, MD

  • Pediatrics Physician
  • Mount Airy, NC
National Provider Identifier
1962463257
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35770 Issued in NC
Practice address
865 W Lake Dr
Mount Airy, NC 27030-2157
Phone
(336) 719-6100
Fax
(336) 719-2313
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35770 NC Primary

Addresses

Primary practice location

865 W Lake Dr
Mount Airy, NC 27030-2157

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 719-6100

Other identifiers 2

IdentifierTypeStateIssuer
8983221MedicaidNC
1962463257MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cthoppil5430@direct.novanthealth.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190508002335 NC Practitioner - Pediatric Medicine 0143461640 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jun 1, 2020 Accepting new patients
NH Digital Health Services, LLC CurrentSince Sep 1, 2020 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Mar 10, 2019 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Mar 10, 2019 Accepting new patients
NH Digital Health Services, LLC CurrentSince Sep 1, 2020 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jun 1, 2020 Accepting new patients
Forsyth Memorial Hospital, Inc Pediatrics Past Accepting new patients

Locations

3545 Whitehall Park Dr
Ste 300
Charlotte, NC 28273
Phone (704) 316-6187

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

865 Westlake Dr
Mount Airy, NC 27030
Phone (336) 719-6100

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2085 Frontis Plaza Blvd
Winston Salem, NC 27103
Phone (336) 277-7226

100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: cthoppil5430@direct.novanthealth.org

Organizations & group practices 8

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1962463257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-719-6100",
            "fax_number": "336-719-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 W LAKE DR",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270302157",
            "telephone_number": "336-719-6100",
            "fax_number": "336-719-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOPPIL",
        "first_name": "CECIL",
        "middle_name": "KOSHEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "35770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8983221",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962463257",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cthoppil5430@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "865 W Lake Dr",
            "city": "Mount Airy",
            "state": "NC",
            "country_code": "US",
            "postal_code": "270302157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Airy, NC

Sources for this page

Verify at the official NPI Registry.