Tima R. Deal, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

6055 Issued in SC

Practice address

101 Brightwater Dr
Myrtle Beach, SC 29579-8275

Phone

(843) 903-8300

NPI assigned

Dec 3, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Synergy Care Southeast LLCGroup PAC ID 6204079163, 193 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Synergy Care Southeast, LLC

  dba Synergy Care Southeast LLC - Texas

  • Physical Therapist
  • Lake Charles, LA
  • NPI 1427466614

  TX

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1417564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1386041515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3158 SE ACCESS RD",
            "city": "MOUNT VERNON",
            "state": "TX",
            "postal_code": "754576914",
            "telephone_number": "930-305-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BRIGHTWATER DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295798275",
            "telephone_number": "843-903-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756014739",
            "country_code": "US",
            "telephone_number": "930-305-5969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAL",
        "first_name": "TIMA",
        "middle_name": "R.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-03",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "102286",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "6055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercedes Zimmerman Davis, PA-C
• Morgan Davis, BCBA
• Rochelle L Davis, LCSW-CP
• Stanley Bernard Davis Jr., BA
• Tyrone Davis
• Mark Tracy Dean, OD
• Deane Counseling LLC
• Thais Deane, LCSW
• Suzanne H Deckelbaum, NP
• Stephen Michael Decker, R.PH.

• Occupational Therapist in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.