Timothy D Wingo, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

24057 Issued in SC

Practice address

3240 Sunset Blvd
West Columbia, SC 29169-3428

Phone

(803) 796-4251

Fax

(803) 796-4449

NPI assigned

Aug 12, 2006

Last updated

Aug 29, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2014 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1457363178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3240 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693428",
            "telephone_number": "803-796-4251",
            "fax_number": "803-796-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3240 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693428",
            "telephone_number": "803-796-4251",
            "fax_number": "803-796-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGO",
        "first_name": "TIMOTHY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "24057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240572",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Lee Wilson, MD
• Joy Strickland Wilson, SLP
• Kala Latral Wilson, PTA
• Shannon Taylor Wilson, MSN
• Haley Wingard, RBT
• Angie Lynn Winterstein, PT
• Winyah Home Health Care, LLC
• Edward McCray Wise Jr., DMD
• Lauryn Shirley Wise, PHARMD
• Melissa Wise

• Family Medicine Physician in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.