Individual provider Active NPI

Timothy F Himel

  • Neurology Physician
  • Kingsport, TN
National Provider Identifier
1548304553
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
51187 Issued in TN
Practice address
130 W Ravine Rd
Kingsport, TN 37660-3837
Phone
(423) 224-3628
Fax
(423) 224-8502
NPI assigned
Feb 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 16212 LA
Neurology Physician 2084N0400X 16212 LA
Neurology Physician 2084N0400X 51187 TN Primary
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X 51187 TN

Addresses

Primary practice location

130 W Ravine Rd
Kingsport, TN 37660-3837

Mailing address

105 W Stone Dr
Suite 6a
Kingsport, TN 37660-3365
Phone (423) 408-7220

Other identifiers 1

IdentifierTypeStateIssuer
1349127MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20140521002490 TN Practitioner - Neurology 2062468598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Louisiana State University School of Medicine in New Orleans, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

111 W Stone Dr
Kingsport, TN 37660-6027

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 230-8200

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111

Hospital & facility affiliations

  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
16212LAMDNeurology Physician
51187TNMDSleep Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates Inc CurrentSince Apr 1, 2014 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Apr 1, 2014 Accepting new patients

Locations

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

105 W Stone Dr
Ste 6A
Kingsport, TN 37660
Phone (423) 408-7220

Organizations & group practices 2

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 1

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1548304553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "SUITE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603837",
            "telephone_number": "423-224-3628",
            "fax_number": "423-224-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMEL",
        "first_name": "TIMOTHY",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "LA",
            "license": "16212",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "16212",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "51187",
            "primary": true
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "TN",
            "license": "51187",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1349127",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.