Individual provider Active NPI

Timothy James Leonard, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1104989128
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
325 Hawthorne LN Ste 100
Charlotte, NC 28204-2536
Phone
(704) 316-7760
Fax
(704) 316-7761
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

325 Hawthorne LN Ste 100
Charlotte, NC 28204-2536

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-7760

Other practice location 1

2300 Randolph Rd
Ste A
Charlotte, NC 28207-1127
Phone (704) 316-7760

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tleonard164699@direct.novanthealth.org
Direct Messaging Address tleonard164699@direct.novanthealth.org

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141010001230 NC Practitioner - Physician Assistant 3072733252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1450 Matthews Township Pkwy
Matthews, NC 28105-2388

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6500

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

325 Hawthorne LN
Suite 100
Charlotte, NC 28204-2536
Phone (704) 316-7760

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Jul 21, 2014 Accepting new patients
Novant Health Medical Group LLC CurrentSince Jul 21, 2014 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

2300 Randolph Rd
Ste A
Charlotte, NC 28207
Phone (704) 372-9393

325 Hawthorne Ln
Ste 100
Charlotte, NC 28204
Phone (704) 316-7763

1450 Matthews Township Pkwy
Ste 110
Matthews, NC 28105
Phone (704) 316-7740

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 4

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

Hospital & facility affiliations 1

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1104989128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-316-7760",
            "fax_number": "704-316-7761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 HAWTHORNE LN STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042536",
            "telephone_number": "704-316-7760",
            "fax_number": "704-316-7761"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Randolph Rd",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071127",
            "country_code": "US",
            "telephone_number": "704-316-7760",
            "fax_number": "704-316-7761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2024-02-21",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tleonard164699@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2300 Randolph Rd",
            "address_2": "Ste A",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071127",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tleonard164699@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "325 Hawthorne Ln Ste 100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.