Individual provider Active NPI

Tia M. Exline, NP

  • Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1124548599
Registry record updated Jun 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5009616 Issued in NC
Practice address
3001 Lyndhurst Ave
Winston Salem, NC 27103-4007
Phone
(336) 765-0383
NPI assigned
Jun 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5009616 NC Primary

Addresses

Primary practice location

3001 Lyndhurst Ave
Winston Salem, NC 27103-4007

Mailing address

2 Oak Ridge Dr
Thomasville, NC 27360-3259
Phone (336) 689-4749

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
I20220103000683 NC Practitioner - Nurse Practitioner 5294126124 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Sep 10, 2021 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Sep 10, 2021 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients

Locations

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

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

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

Interoperability endpoints

  • Direct secure messaging: texline453085@direct.novanthealth.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498435200000",
    "number": "1124548599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 OAK RIDGE DR",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273603259",
            "telephone_number": "336-689-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 LYNDHURST AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034007",
            "telephone_number": "336-765-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EXLINE",
        "first_name": "TIA",
        "middle_name": "M.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-26",
        "last_updated": "2017-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5009616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.