Timothy Marc Wilks, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

200100198 Issued in NC

Practice address

100 Brewster Blvd
Naval Hospital
Camp Lejeune, NC 28547-2538

Phone

(910) 450-4159

Fax

(910) 450-4194

NPI assigned

Dec 19, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1043296361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "telephone_number": "910-450-4159",
            "fax_number": "910-450-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "NAVAL HOSPITAL",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "telephone_number": "910-450-4159",
            "fax_number": "910-450-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKS",
        "first_name": "TIMOTHY",
        "middle_name": "MARC",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "200100198",
            "primary": true
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "NC",
            "license": "200100198",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin S Whitmore, DDS
• Anthony Joseph Wick
• David John Wilde
• Bailey Caroline Wilkes
• Craig Allen Wilkins, DNP, CRNA
• Austin Willard, SOIDC
• Peter Willett, M.D.
• Ameliann B Williams, MD
• Jason James Williams, IDC
• Necia L Williams, M.D.

• Pediatrics Physician in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.