Individual provider Active NPI

Timothy J Burrell, MD

  • Family Medicine Physician
  • Spartanburg, SC
National Provider Identifier
1457672289
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32853 Issued in SC
Practice address
2191 Southport Rd
Spartanburg, SC 29306-6257
Phone
(864) 215-4840
Fax
(864) 583-5485
NPI assigned
Jun 16, 2010
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
Family Medicine Physician 207Q00000X LL32853 SC
Family Medicine Physician 207Q00000X 32853 SC Primary

Addresses

Primary practice location

2191 Southport Rd
Spartanburg, SC 29306-6257

Mailing address

PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304

Other identifiers 6

IdentifierTypeStateIssuer
328531MedicaidSC
SC03156121OtherSCMEDICARE PIN
SC03156084OtherSCMEDICARE PIN
SC0315J577OtherSCMEDICARE PIN
SC0315OtherSCMEDICARE #
SC03156067OtherSCMEDICARE PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tburrell179686@direct-srhs.et0939.epichosted.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20130129000653 SC Practitioner - Family Practice 3173777042 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, shared by 17 NPIs, 1,060 clinicians

Practice addresses (Care Compare)

1200 E Main St
Suite 12
Spartanburg, SC 29307-1738
Phone (864) 560-9260

840 W Floyd Baker Blvd
Gaffney, SC 29341-1845
Phone (864) 489-3300

Hospital & facility affiliations

  • Spartanburg Medical Center Hospital, Spartanburg, SC, CCN 420007
  • Pelham Medical Center Hospital, Greer, SC, CCN 420103

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32853SCMDFamily Medicine Physician
LL32853SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center Family Medicine CurrentSince Mar 19, 2019 Accepting new patients
Spartanburg Medical Center CurrentSince Jan 1, 2019 Accepting new patients
Spartanburg Medical Center Family Medicine Current Accepting new patients
Cherokee Medical Center Family Medicine CurrentSince Oct 1, 2019 Accepting new patients
Cherokee Medical Center CurrentSince Oct 1, 2019 Accepting new patients
Cherokee Medical Center Family Medicine Current Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center Family Medicine CurrentSince Jan 1, 2019 Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

3981 Highway 9
Boiling Springs, SC 29316
Phone (864) 560-3650

3941 Highway 9
#B
Boiling Springs, SC 29316
Phone (864) 585-2765

840 W Floyd Baker Blvd
Gaffney, SC 29341
Phone (864) 489-3300

1341 N Limestone St
Gaffney, SC 29340
Phone (864) 489-3300

853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928

2660 Reidville Rd
Unit 1
Spartanburg, SC 29301
Phone (864) 560-9696

2191 Southport Rd
Spartanburg, SC 29306
Phone (864) 216-4680

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

1200 E Main St
Ste 12
Spartanburg, SC 29307
Phone (864) 560-9260

1690 Skylyn Dr
Ste 210
Spartanburg, SC 29307
Phone (864) 253-8170

151 Peachwood Centre Dr
Spartanburg, SC 29301
Phone (864) 560-9627

511 Cross Anchor Rd
Woodruff, SC 29388
Phone (864) 278-6031

Organizations & group practices 9

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 6

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": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1457672289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743070",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743070",
            "telephone_number": "864-560-4304",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 SOUTHPORT RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293066257",
            "telephone_number": "864-215-4840",
            "fax_number": "864-583-5485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRELL",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL32853",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "32853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "328531",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC03156121",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC03156084",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC0315J577",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE #",
            "identifier": "SC0315",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SC03156067",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tburrell179686@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tburrell179686@direct-srhs.et0939.epichosted.com",
            "address_1": "2191 Southport Rd",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293066257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.