TIMOTHY STARLING ROUSH M.D. NPI 1720091499

NPI Information

NPI: 1720091499
Provider Name: TIMOTHY STARLING ROUSH, M.D.
Classification: Surgery - 2086S0129X
Entity Type: Individual

Specialization: Vascular Surgery

Address:
1001 BLYTHE BLVD
SUITE 300 - CARDIAC SURGERY:
CHARLOTTE, NC
ZIP 28203
Phone: (704) 373-0212
Get Directions

Timothy Starling Roush, M.D. is a vascular surgery surgery in Charlotte, NC. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. Timothy Starling Roush, M.D. NPI is 1720091499. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1001 BLYTHE BLVD
SUITE 300 - CARDIAC SURGERY:
CHARLOTTE, NC
ZIP 28203-863
Phone: (704) 373-0212
Fax: (704) 372-1249

The enumeration date for this NPI number is 8/14/2006 and was last updated on 12/5/2016.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208600000X	Surgery		35-069667	OHIO	No
2	208600000X	Surgery		200100085	NORTH CAROLINA	No
3	2086S0129X	Surgery	Vascular Surgery	200100085	NORTH CAROLINA	Yes
4	2086S0129X	Surgery	Vascular Surgery	35-069667	OHIO	No

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	128A4	OTHER	NORTH CAROLINA	BCBS
2	89128A4	MEDICAID	NORTH CAROLINA
3	N0076B	MEDICAID	SOUTH CAROLINA
4	1720091499	MEDICAID	NORTH CAROLINA
5	P00200674	OTHER		RAILROAD MEDICARE
6	G18878	MEDICARE UPIN
7	2282428A	MEDICARE PIN	NORTH 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

NPI Synchronization or Removal

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