Organization Active NPI

Tracy M Timony, MD LLC

  • Internal Medicine Physician
  • Rock Hill, SC
National Provider Identifier
1528389350
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
15793 Issued in SC
Legal business name
TRACY M TIMONY, MD LLC
Practice address
430 S Herlong Ave
Rock Hill, SC 29732-9446
Phone
(803) 324-4008
NPI assigned
Jun 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Authorized official

Name
Tracy M TimonyNPI 1063404945
Title
Owner
Phone
(803) 324-4008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 15793 SC Primary

Addresses

Primary practice location

430 S Herlong Ave
Rock Hill, SC 29732-9446

Mailing address

430 S Herlong Ave
Rock Hill, SC 29732-9446
Phone (803) 324-4008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101025001389 SC Part B Supplier - Clinic/Group Practice 5193918985 Receives reassigned benefits from 1 practitioner
Practice locations: Rock Hill, SC

National Provider Directory

National Provider Directory

Locations

1665 Herlong Ct
Rock Hill, SC 29732
Phone (803) 324-1028

430 Herlong Ave S
Ste 102
Rock Hill, SC 29732
Phone (803) 324-8004

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15159/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282780800000",
    "number": "1528389350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 S HERLONG AVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297329446",
            "telephone_number": "803-324-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 S HERLONG AVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297329446",
            "telephone_number": "803-324-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY M TIMONY, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-16",
        "last_updated": "2010-08-26",
        "status": "A",
        "authorized_official_last_name": "TIMONY",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-324-4008"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "15793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.