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TIMOTHY DWIGHT EDMISTEN MD NPI 1780679357


NPI Information

NPI: 1780679357
Provider Name: TIMOTHY DWIGHT EDMISTEN, MD
Classification: Surgery - 208600000X
Entity Type: Individual

PECOS Registration: Yes

Address:
965 STATE FARM RD
BOONE, NC
ZIP 28607
Phone: (828) 264-2340
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Timothy Dwight Edmisten, MD is a surgery in Boone, NC with 31 years of experience. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. Timothy Dwight Edmisten, MD NPI is 1780679357. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: BRODY SCHOOL OF MEDICINE AT EAST CAROLINA UNIVERSITY
Graduation Year:1993

The provider's business location address is:

965 STATE FARM RD
BOONE, NC
ZIP 28607-948
Phone: (828) 264-2340
Fax: (828) 262-0731

The NPI 1780679357 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Biopsy of the esophagus, stomach, and/or upper small bowel using an endoscope (HCPCS:43239)
  • Biopsy of large bowel using an endoscope (HCPCS:45380)
  • Removal of polyps or growths of large bowel using an endoscope (HCPCS:45385)

The enumeration date for this NPI number is 9/20/2005 and was last updated on 3/10/2023.


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
12086S0129XSurgeryVascular Surgery9800856NORTH CAROLINANo
2208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)9800856NORTH CAROLINANo
3208600000XSurgery9800856NORTH 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1891227RMEDICAIDNORTH 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: 5/5/2024

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.