Timberlake Health and Wellness

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

Legal business name

TIMBERLAKE HEALTH AND WELLNESS

Doing business as

Timberlake Health and Wellness

Practice address

22776 Timberlake Rd Apt D
Lynchburg, VA 24502-7310

Phone

(434) 237-6337

Fax

(434) 237-6338

NPI assigned

Mar 8, 2007

Last updated

Sep 16, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

BLUE RIDGE APOTHECARY INCAs reported in NPPES

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

Authorized official

Name

Jodi V. Ettare, R.PH.NPI 1245412964

Title

Supervising Pharmacist

Phone

(434) 237-6337

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Timberlake Health and Wellness Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Blue Ridge Apothecary Inc

  dba Blue Ridge Apothecary

  • Compounding Pharmacy
  • Roanoke, VA
  • NPI 1447670849
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jodi V. Ettare, PHARM.D.

  • Pharmacotherapy Pharmacist
  • Lynchburg, VA
  • NPI 1245412964
  NPD Authorized official
• Warren Booker

  • Pharmacist
  • Lynchburg, VA
  • NPI 1649796855
  NPD (past)
• James Vincent Ettare II, PHARMD

  • Pharmacist
  • Lynchburg, VA
  • NPI 1477505782
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1083745509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22776 TIMBERLAKE RD APT D",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245027310",
            "telephone_number": "434-237-6337",
            "fax_number": "434-237-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22776 TIMBERLAKE RD APT D",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245027310",
            "telephone_number": "434-237-6337",
            "fax_number": "434-237-6338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMBERLAKE HEALTH AND WELLNESS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLUE RIDGE APOTHECARY INC",
        "enumeration_date": "2007-03-08",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "ETTARE",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "434-237-6337",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "VA",
            "license": "0201004144",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "VA",
            "license": "0201004144",
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EFT PROVIDER NO.",
            "identifier": "00F10H",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Timberlake Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Timberlake Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cary Tichenor, PT, DPT
• Tidewater Physical Therapy LLC (Pivot Physical Therapy of Virginia)
• William Alexander Tidwell, LUCOM MED STUDENT
• Gregory K Tilley, D.C.
• Melinda Tilley
• Jennifer Jinus Tinoosh, DC
• Anita Elaine Tinsley
• Lillian Eve Tipton
• David A Titcomb, PT, DPT
• Ronald Lee Todd, D.D.S.

• Compounding Pharmacy in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Compounding Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.