DR. THOMAS KERN CARLTON III M.D.
NPI 1235263971
Rehabilitation Practitioner in Charlotte, NC

NPI Status: Active since March 15, 2007

Contact Information

2610 E 7TH ST
CHARLOTTE, NC
ZIP 28204
Phone: (704) 375-8900
Fax: (704) 335-7178

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Rehabilitation Practitioner
Accepts Insurance
PECOS Enrolled

About THOMAS CARLTON

This page provides the complete NPI Profile along with additional information for Thomas Carlton, a provider established in Charlotte, North Carolina with a medical specialization in Rehabilitation Practitioner. The healthcare provider is registered in the NPI registry with number 1235263971 assigned on March 2007. The practitioner's primary taxonomy code is 225400000X with license number 9300056 (NC). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI: 1235263971
Provider Name: DR. THOMAS KERN CARLTON III M.D.
Gender: Male
Entity Type: Individual
Location Address: 2610 E 7TH ST CHARLOTTE, NC 28204
Location Phone: (704) 375-8900
Location Fax: (704) 335-7178
Mailing Address: 2610 E 7TH ST CHARLOTTE, NC 28204
Mailing Phone: (704) 375-8900
Mailing Fax: (704) 335-7178
Is Sole Proprietor?: No
Enumeration Date: 03-15-2007
Last Update Date: 03-07-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Rehabilitation Practitioner
Taxonomy Code: 225400000X
Type: Respiratory, Developmental, Rehabilitative and Restorative Service Providers
License No.: 9300056
License State: NC
Taxonomy Description: A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Blue Cross and Blue Shield of NC

Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors - PPO
Blue Advantage Bronze Standard | Nationwide Doctors - PPO
Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
Blue Advantage Gold Standard A | Nationwide Doctors - PPO
Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
Blue Advantage Silver Standard | Nationwide Doctors - PPO
Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors - HMO
Blue Care Bronze Complete | $60 PCP | $20 Tier 1 Rx | Statewide Doctors - HMO
Blue Care Bronze HSA Eligible | Integrated | Statewide Doctors - HMO
Blue Care Bronze Standard | Statewide Doctors - HMO
Blue Care Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Statewide Doctors - HMO
Blue Care Gold Standard A | Statewide Doctors - HMO
Blue Care Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Statewide Doctors - HMO
Blue Care Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Statewide Doctors - HMO
Blue Care Silver Standard | Statewide Doctors - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Thomas Carlton is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1235263971, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 69. The final step is to find the difference between that total and the next multiple of ten (70 - 69 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 6

Pos 4

Unchanged

Pos 5

Doubled → 4

Pos 6

Unchanged

Pos 7

Doubled → 6

Pos 8

Unchanged

Pos 9

Doubled → 14 → 1 + 4

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 2 → 4 3 → 6 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 6 + 5 + 4 + 6 + 6 + 9 + 1 + 4 + 24 = 69

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 69 is 70. The difference is the calculated check digit.

70 - 69 = 1

This NPI is valid

The calculated check digit is 1, which matches the last digit of 1235263971.