Provider Demographics
NPI:1255310793
Name:CAMPION, THOMAS S (PT, OCS)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:S
Last Name:CAMPION
Suffix:
Gender:M
Credentials:PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10370 PARK RD
Mailing Address - Street 2:STE 102
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-8509
Mailing Address - Country:US
Mailing Address - Phone:866-679-1600
Mailing Address - Fax:864-679-1605
Practice Address - Street 1:3135 SPRINGBANK LN
Practice Address - Street 2:SUITE 220
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3360
Practice Address - Country:US
Practice Address - Phone:704-541-3378
Practice Address - Fax:704-542-5962
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC52572251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC06-1644099OtherTAX ID
NC078C0OtherBCBS INDIVIDUAL
NC016MNOtherBCBS GROUP
NC7211690Medicaid
NC7211690Medicaid