DR. THOMAS JACKSON VANDIVER MD
NPI 1902896756
Obstetrics & Gynecology - Gynecology in Charlotte, NC

Q: What is Thomas Vandiver's NPI number?

The NPI number for Thomas Vandiver is 1902896756. It was assigned to this individual provider in the NPPES registry on October 24, 2005.

Q: What is Thomas Vandiver's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecology, with taxonomy code 207VG0400X.

Q: When was this NPI record last updated?

The NPPES record for Thomas Vandiver was last updated on March 11, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 24, 2005PECOS Enrolled

150 PROVIDENCE RD, CHARLOTTE, NC 28207(704) 973-2106(704) 973-2395 Get Directions Write a Review

NPPES record last updated: March 11, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Dr. Thomas Jackson Vandiver Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THOMAS JACKSON VANDIVER MD (NPI 1902896756) is an individual gynecology provider in Charlotte, North Carolina, licensed in North Carolina (24305) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902896756

Entity TypeIndividualMale

Primary Taxonomy207VG0400X

Provider Legal NameDR. THOMAS JACKSON VANDIVERCredential: MD

Location Address150 PROVIDENCE RDCharlotte, NC 28207-1218

Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 973-2106 · Fax (704) 973-2395

Phone(704) 973-2106

Fax(704) 973-2395

Sole ProprietorNo

Enumeration DateOctober 24, 2005

Last NPPES UpdateMarch 11, 2015

✔ NPI 1902896756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207VG0400X

License✔ Licensed in NC · 24305

Definition

A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee

150 PROVIDENCE RD, Charlotte, NC 28207

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Other Identifiers 3

Medicare UPINC86892

Medicaid8984676NC

Medicare ID-Type Unspecified211144BNC

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Thomas Jackson Vandiver Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Thomas Vandiver reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Novant Medical Group, Inc.

0.2 mi

Sleep Medicine

1900 RANDOLPH RD STE 1010
Charlotte, NC 28207

Reassigned Medicare billing, North Carolina enrollment
Medicare enrollment name: Novant Health Medical Group, LLC
561 clinicians in this Medicare group

NPI 1477092179 (704) 316-1062

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28207 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$125.01 typical visit price

range $54.12 – $165.09

Typical copayment $31.25 (range $13.53 – $41.27)

Most-billed visit code 99204

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

81%63 patients4/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

33%84 patients2/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

47%210 patients2/55-star benchmark: 100%

Screening for Osteoporosis for Women Aged 65-85 Years of Age

Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis

29%72 patients2/55-star benchmark: 98%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. STEPHEN CHARLES MOORE MD

Obstetrics & Gynecology