Individual provider Active NPI

Timothy Wayne Champion, FNP-CFRN-NRP

  • Family Nurse Practitioner
  • Calhoun, GA
National Provider Identifier
1316439532
Registry record updated Jun 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN135837 Issued in GA
Practice address
251 Highway 53 E
Calhoun, GA 30701-3026
Phone
(706) 625-4410
NPI assigned
Jun 4, 2018
Last updated
Jun 4, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN135837 GA Primary

Addresses

Primary practice location

251 Highway 53 E
Calhoun, GA 30701-3026

Mailing address

420 E 2ND Ave Ste 103
Rome, GA 30161-3210
Phone (706) 509-3000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180727002284 GA Practitioner - Nurse Practitioner 8022365691 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chattooga River Physicians, LLCGroup PAC ID 8820443575, 19 clinicians
Floyd Healthcare Management IncGroup PAC ID 5193633386, 133 clinicians

Practice addresses (Care Compare)

13583 Hwy 27
Trion, GA 30753-1511
Phone (706) 238-8360

251 Hwy 53 E
Calhoun, GA 30701-3026
Phone (706) 625-4410

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
98.9 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chattooga River Physicians, LLC CurrentSince Oct 15, 2023 Accepting new patients
Etowah Emergency Physicians, LLC CurrentSince Jun 1, 2018 Accepting new patients
Floyd Healthcare Management Inc CurrentSince Jul 1, 2018 Accepting new patients
Harbin Clinic, LLC CurrentSince Jul 4, 2026 Accepting new patients
Floyd Healthcare Management Inc Family CurrentSince Jul 1, 2018 Accepting new patients
Etowah Emergency Physicians, LLC CurrentSince Jun 1, 2018 Accepting new patients
Harbin Clinic, LLC PastSince Jul 4, 2026 Accepting new patients

Locations

251 Highway 53 E
Calhoun, GA 30701
Phone (706) 602-8200

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

2360 Rockmart Hwy
Cedartown, GA 30125
Phone (770) 748-2500

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

330 Turner McCall Blvd SW
Ste 107
Rome, GA 30165
Phone (706) 509-6439

420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278

11766 Highway 27
Ste A
Summerville, GA 30747
Phone (706) 230-4240

13583 Highway 27
Trion, GA 30753
Phone (706) 238-8360

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 7

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

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": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1316439532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 2ND AVE STE 103",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613210",
            "telephone_number": "706-509-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 HIGHWAY 53 E",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307013026",
            "telephone_number": "706-625-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPION",
        "first_name": "TIMOTHY",
        "middle_name": "WAYNE",
        "credential": "FNP-CFRN-NRP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN135837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calhoun, GA

Sources for this page

Verify at the official NPI Registry.