Individual provider Active NPI

Thomas Joseph Gennosa, MD

  • Family Medicine Physician
  • Robersonville, NC
National Provider Identifier
1962483446
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9900506 Issued in NC
Practice address
504 N Main St
Robersonville, NC 27871-9567
Phone
(252) 795-5555
Fax
(252) 795-5566
NPI assigned
Nov 10, 2005
Last updated
Oct 19, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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 9900506 NC Primary

Addresses

Primary practice location

504 N Main St
Robersonville, NC 27871-9567

Mailing address

504 N Main St
Robersonville, NC 27871-9567
Phone (252) 795-5555

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
I20090623000323 NC Practitioner - Family Practice 3577614049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

504 N Main St
Robersonville, NC 27871-9567
Phone (252) 795-5555

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Robersonville Physicians PC CurrentSince Jan 1, 2003 Accepting new patients
Williamston Clinic Corp Family Medicine PastSince Sep 5, 2021 Accepting new patients

Locations

504 N Main St
Robersonville, NC 27871
Phone (252) 795-5555

107 W Saint John St
Tarboro, NC 27886
Phone (252) 823-4300

Interoperability endpoints

  • Direct secure messaging: gennosa.thomas.001.0330112@roph.meditab.direct-ci.com
  • Direct secure messaging: gennosa.thomas.004.0330112@roph.meditab.direct-ci.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.

Hospital & facility affiliations 5

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1962483446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 N MAIN ST",
            "city": "ROBERSONVILLE",
            "state": "NC",
            "postal_code": "278719567",
            "telephone_number": "252-795-5555",
            "fax_number": "252-795-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N MAIN ST",
            "city": "ROBERSONVILLE",
            "state": "NC",
            "postal_code": "278719567",
            "telephone_number": "252-795-5555",
            "fax_number": "252-795-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENNOSA",
        "first_name": "THOMAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9900506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robersonville, NC

Sources for this page

Verify at the official NPI Registry.