Individual provider Active NPI

Timothy Quinn Van Noy, M.D.

  • Pediatrics Physician
  • North Wilkesboro, NC
National Provider Identifier
1508970831
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
9700790 Issued in NC
Practice address
1925 W Park Dr
North Wilkesboro, NC 28659-3564
Phone
(336) 903-0147
Fax
(336) 903-1687
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 9700790 NC Primary

Addresses

Primary practice location

1925 W Park Dr
North Wilkesboro, NC 28659-3564

Mailing address

1925 W Park Dr
North Wilkesboro, NC 28659-3564
Phone (336) 903-0147

Other identifiers 1

IdentifierTypeStateIssuer
891046CMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9700790NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wilkes Pediatric Clinic, PLLC Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: van-noy.timothy.002.0330023@wpc.meditab.direct-ci.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508970831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 W PARK DR",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593564",
            "telephone_number": "336-903-0147",
            "fax_number": "336-903-1687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 W PARK DR",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593564",
            "telephone_number": "336-903-0147",
            "fax_number": "336-903-1687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN NOY",
        "first_name": "TIMOTHY",
        "middle_name": "QUINN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9700790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891046C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Wilkesboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.