Individual provider Active NPI

Timothy Ryan Schenk, PA-C

  • Surgical Physician Assistant
  • Salisbury, NC
National Provider Identifier
1154560449
Registry record updated Feb 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0010-01716 Issued in NC
Practice address
605 Grove St
Salisbury, NC 28144-3233
Phone
(704) 633-6442
Fax
(704) 633-7569
NPI assigned
Feb 11, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0010-01716 NC Primary

Addresses

Primary practice location

605 Grove St
Salisbury, NC 28144-3233

Mailing address

605 Grove Street
Salisbury, NC 28144-3233
Phone (704) 633-6442

Other names 1

  • Ryan Schenk Other name

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
I20090421000174 NC Practitioner - Physician Assistant 7810044674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

250 Hospital Dr
Lexington, NC 27292-6792
Phone (336) 716-2734

320 Jake Alexander Blvd W
Suite 106
Salisbury, NC 28147-1442
Phone (704) 636-0052

605 Grove St
Salisbury, NC 28144-3233
Phone (704) 633-6442

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Kernersville, NC, CCN 347318
  • Lexington Memorial Hospital Inc Hospital, Lexington, NC, CCN 340096
  • Novant Health Rowan Medical Center Hospital, Salisbury, NC, CCN 340015
  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01716NCMDDiagnostic Radiology Physician
0010-01716NCMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jun 1, 2013 Accepting new patients

Locations

605 Grove St
Salisbury, NC 28144
Phone (704) 633-6442

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 1

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 8

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": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234310400000",
    "number": "1154560449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 GROVE STREET",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281443233",
            "telephone_number": "704-633-6442",
            "fax_number": "704-633-7569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 GROVE ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281443233",
            "telephone_number": "704-633-6442",
            "fax_number": "704-633-7569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHENK",
        "first_name": "TIMOTHY",
        "middle_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-11",
        "last_updated": "2009-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-01716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RYAN",
            "last_name": "SCHENK",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.