Timothy Marshall Hackler

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-04921 Issued in NC

Practice address

100 Brewster Blvd
Camp Lejeune, NC 28547-2538

Phone

(910) 450-3905

NPI assigned

Jan 4, 2007

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1043367170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 SPANN RD",
            "city": "TRENTON",
            "state": "NC",
            "postal_code": "285857845",
            "telephone_number": "910-478-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472538",
            "telephone_number": "910-450-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKLER",
        "first_name": "TIMOTHY",
        "middle_name": "MARSHALL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "1073868",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Michael Guthrie, PT
• Lino A Gutierrez III, MD
• Sean V Gutierrez, I.D.C.
• Eva R Guyer, M.D.
• Samantha Rae Gwin, MS, RD, CSSD, LD
• Catherine Ellen Hagan, MD
• David William Hagedorn, PH.D.
• Devin Charles Hale, D.O.
• Alexandra Elizabeth Hall, PA-C
• Corbett Scott Hall, DO

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.