NPIMap

Individual provider Active NPI

Timothy John Shea, MD

  • Family Medicine Physician
  • Brevard, NC
National Provider Identifier
1033160346
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9800693 Issued in NC
Practice address
1409 Asheville Hwy
Brevard, NC 28712-9524
Phone
(828) 435-8400
Fax
(828) 435-8401
NPI assigned
May 12, 2006
Last updated
Jan 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9800693 NC Primary

Addresses

Primary practice location

1409 Asheville Hwy
Brevard, NC 28712-9524

Mailing address

PO Box 602373
Charlotte, NC 28260-2373
Phone (828) 213-1500

Other practice location 1

187 Medical Park Dr
Brevard, NC 28712-4189
Phone (828) 884-9362

Other identifiers 5

IdentifierTypeStateIssuer
NC6503COtherNCMEDICARE PTAN
NC6503BOtherNCMEDICARE PTAN
NC6503DOtherNCMEDICARE PTAN
2254955BOtherNCMEDICARE PTAN
NC6503AOtherNCMEDICARE PTAN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tshea227125@direct.UNC.nchie.net Direct
Direct Messaging Address missionhealth@direct.msj.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080304000120 NC Practitioner - Family Practice 1557445335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Albany Medical College of Union University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1409 Asheville Hwy
Brevard, NC 28712-9524
Phone (828) 435-8400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson County Hospital Corporation CurrentSince Sep 1, 2022 Accepting new patients
Hendersonville Hematology and Oncology@Pardee Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1033160346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602373",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602373",
            "telephone_number": "828-213-1500",
            "fax_number": "828-651-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 ASHEVILLE HWY",
            "city": "BREVARD",
            "state": "NC",
            "postal_code": "287129524",
            "telephone_number": "828-435-8400",
            "fax_number": "828-435-8401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "187 Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Brevard",
            "state": "NC",
            "postal_code": "287124189",
            "country_code": "US",
            "telephone_number": "828-884-9362",
            "fax_number": "828-884-3851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEA",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2022-01-07",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9800693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NC6503C",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NC6503B",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NC6503D",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2254955B",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NC6503A",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tshea227125@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1409 Asheville Hwy",
            "city": "Brevard",
            "state": "NC",
            "country_code": "US",
            "postal_code": "287129524",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "missionhealth@direct.msj.org",
            "affiliation": "N",
            "address_1": "187 Medical Park Dr",
            "city": "Brevard",
            "state": "NC",
            "country_code": "US",
            "postal_code": "287124189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Brevard, NC

Sources for this page

Verify at the official NPI Registry.