Timothy James Eden, AGACNP-BC
Individual provider Active NPI Nurse Practitioner · Dover, DE
NPI 1497936652 · NPPES record last updated Aug 16, 2022
Key facts
- NPI
- 1497936652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- LP-0010395 (DE)
- Practice address
- 540 S Governors Ave Ste 100
Dover, DE 19904-3530 - Phone
- (302) 526-1470
- Fax
- (302) 674-1398
- NPI assigned
- Nov 16, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 22
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bayhealth Medical Center, Inc
Practice addresses (Care Compare)
640 S State St
Dover, DE 19901-3530
Hospital & facility affiliations
- Bayhealth Medical Center, Kent Campus
- Bayhealth Hospital, Sussex Campus
- Christiana Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121017000536 | DE | Practitioner - Nurse Practitioner | 1557511102 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L1-0031700 | DE | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bayhealth Medical Center, Inc. | Current | Accepting new patients | |
| Bayhealth Medical Center, Inc | Current |
Accepting new patients | |
| Christiana Care Health Services Inc | Current |
Accepting new patients | |
| Bayhealth Medical Center, Inc. | Current | Accepting new patients | |
| Christiana Care Health Services Inc | Current |
Accepting new patients | |
| Christiana Care Health Services Inc | Nurse Practitioner | Current |
Accepting new patients |
| Bayhealth Medical Center, Inc | Current |
Accepting new patients | |
| Bayhealth Medical Center, Inc. | Current |
Accepting new patients | |
| Bayhealth Medical Center, Inc | Past | Accepting new patients |
Locations
540 S Governors Ave
Ste 100
Dover, DE 19904
Phone (302) 526-1470
640 S State St
#3055
Dover, DE 19901
Phone (302) 480-1688
640 S State St
Dover, DE 19901
Phone (302) 744-4700
100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311
101 Wellness Way
Ste 250
Milford, DE 19963
Phone (302) 744-6220
18383 Hudson Rd
Ste B
Milton, DE 19968
Phone (302) 725-3499
774 Christiana Rd
Ste 201
Newark, DE 19713
Phone (302) 623-3017
4755 Ogletown Stanton Rd
Ste 2E99
Newark, DE 19718
Phone (302) 623-3017
200 Hygeia Dr
Ste 2300
Newark, DE 19713
Phone (302) 623-7362
501 W 14th St
Wilmington, DE 19801
Phone (302) 320-4411
1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | L1-0031700 | DE | |
| Adult Health Nurse Practitioner | 363LA2200X | LB-0000204 | DE | |
| Critical Care Medicine Nurse Practitioner | 363LC0200X | LB-0000204 | DE | |
| Nurse Practitioner | 363L00000X | LP-0010395 | DE | Yes |
Addresses
Primary practice location
540 S Governors Ave Ste 100
Dover, DE 19904-3530
Mailing address
640 S. State Street
Mail Code 3055
Dover, DE 19901-3530
Phone (302) 480-1688
Other providers in Dover, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.