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TIMA WELLNESS PA NPI 1609260942


NPI Information

NPI: 1609260942
Provider Name: TIMA WELLNESS PA
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 34D2096166

Address:
1591 YANCEYVILLE STREET
SUITE 200A
GREENSBORO, NC
ZIP 27405
Phone: (336) 907-3006
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TIMA WELLNESS PA is an internal medicine in Greensboro, NC. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. TIMA WELLNESS PA NPI is 1609260942. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1591 YANCEYVILLE STREET
SUITE 200A
GREENSBORO, NC
ZIP 27405-941
Phone: (336) 907-3006
Fax: (336) 663-8421

The provider's authorized official is Byron Gladden .
The authorized official title is Practice Manager and has the following contact phone number (336) 907-3006.

The CLIA number assigned to this NPI record is 34D2096166 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/25/2015 and was last updated on 11/30/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine95-01417NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18975633MEDICAIDNORTH CAROLINA
22219644AMEDICARE PINNORTH CAROLINA
3G19903MEDICARE UPINNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.