Individual provider Active NPI

Timothy John Stevens, M.D.

  • Surgical Critical Care Physician
  • Gainesville, GA
National Provider Identifier
1174966337
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
86638 Issued in GA
Practice address
1211 Sherwood Park Dr NE Ste a
Gainesville, GA 30501-3444
Phone
(770) 219-3202
NPI assigned
Apr 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 86638 GA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1211 Sherwood Park Dr NE Ste a
Gainesville, GA 30501-3444

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

960 E 3rd St
Suite 104
Chattanooga, TN 37403-2104
Phone (423) 778-7695

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tstevens106885@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200814000503 GA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 2769623099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
University of Cincinnati College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Georgia Physicians Group IncGroup PAC ID 6901898386, 884 clinicians

Practice addresses (Care Compare)

1211 Sherwood Park Dr NE
Suite a
Gainesville, GA 30501-3444
Phone (770) 219-3202

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • Northeast Georgia Medical Center Lumpkin Hospital, Dahlonega, GA, CCN 110237
  • Union General Hospital Hospital, Blairsville, GA, CCN 110051
  • Stephens County Hospital Hospital, Toccoa, GA, CCN 110032
  • Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc CurrentSince Jul 15, 2020 Accepting new patients
Northeast Georgia Medical Center, Inc. Past Accepting new patients

Locations

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

1211 Sherwood Park Dr NE
Ste A
Gainesville, GA 30501
Phone (770) 219-3202

Organizations & group practices 2

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 5

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": "1365379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1174966337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 SHERWOOD PARK DR NE STE A",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013444",
            "telephone_number": "770-219-3202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "960 E 3rd St",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374032104",
            "country_code": "US",
            "telephone_number": "423-778-7695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "GA",
            "license": "86638",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tstevens106885@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1211 Sherwood Park Dr NE Ste A",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.