Timika Walker Gorham, LICENSE PRACTICAL

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

92226 Issued in NC

Practice address

150 E Arlington Blvd Ste C
Greenville, NC 27858-5019

Phone

(252) 353-2555

Fax

(252) 565-0137

NPI assigned

Mar 22, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Sellati & Co., Inc.

  dba Greenville Recovery Center

  • Methadone Clinic
  • Greenville, NC
  • NPI 1629212907
  NPD

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1497458327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E ARLINGTON BLVD STE C",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585019",
            "telephone_number": "252-353-2555",
            "fax_number": "252-565-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E ARLINGTON BLVD STE C",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585019",
            "telephone_number": "252-353-2555",
            "fax_number": "252-565-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORHAM",
        "first_name": "TIMIKA",
        "middle_name": "WALKER",
        "credential": "LICENSE PRACTICAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "92226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Michelle Gordon, DDS
• Teddie Wayne Gore, FNP
• Scott Gorecke
• Haley N Gorham, BSN, RN
• Kayla Niquel Gorham
• William Thomas Gorham Jr.
• Ambre Gorsek, M.S., CCC-SLP
• Alexis Pierino Goss, PA-C
• Karen Mary Goth, M.D.
• Tafadzwa Precious Goto, NP

• Licensed Practical Nurse in Greenville, NC
• Providers in Greenville, NC by specialty
• Licensed Practical Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.