Individual provider Active NPI

Thomas Johnston Patrick Jr., DPM

  • Podiatrist
  • Spartanburg, SC
National Provider Identifier
1992726319
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
72 Issued in SC
Practice address
184 Oakland Ave
Spartanburg, SC 29302-1669
Phone
(864) 582-8570
Fax
(864) 585-3528
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 72 SC Primary

Addresses

Primary practice location

184 Oakland Ave
Spartanburg, SC 29302-1669

Mailing address

184 Oakland Ave
Spartanburg, SC 29302-1669
Phone (864) 582-8570

Other identifiers 2

IdentifierTypeStateIssuer
PD0724MedicaidSC
P00315353OtherSCRAILROAD MEDICARE PROV #

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050929000190 SC Practitioner - Podiatry 3375578263 Reassigns benefits to 1 organization
Practice locations: Greenville, SC; Woodruff, SC; Union, SC; Spartanburg, SC; Six Mile, SC; Simpsonville, SC; Piedmont, SC; Lyman, SC…

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

184 Oakland Ave
Spartanburg, SC 29302-1669
Phone (864) 582-8570

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue25
Removal or shaving of skin growth11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
360Care LLC Podiatrist CurrentSince Feb 3, 2020 Accepting new patients
360Care LLC CurrentSince Feb 3, 2020 Accepting new patients
Thomas Patrick Podiatrist PastSince Jan 1, 1990 Accepting new patients
Ecp South Carolina, P.a. Past Accepting new patients
Inpatient Consultants of North Carolina, PC Past Accepting new patients

Locations

4350 Brownsboro Rd
Ste 200
Louisville, KY 40207
Phone (513) 771-7483

1703 Laurel St
Columbia, SC 29201
Phone 24852821166

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992726319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 OAKLAND AVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021669",
            "telephone_number": "864-582-8570",
            "fax_number": "864-585-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 OAKLAND AVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021669",
            "telephone_number": "864-582-8570",
            "fax_number": "864-585-3528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "THOMAS",
        "middle_name": "JOHNSTON",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "SC",
            "license": "72",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PD0724",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROV #",
            "identifier": "P00315353",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.