Tima Wellness PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

95-01417 Issued in NC

Legal business name

TIMA WELLNESS PA

Practice address

1591 Yanceyville Street
Suite 200a
Greensboro, NC 27405-6941

Phone

(336) 907-3006

Fax

(336) 663-8421

NPI assigned

Mar 25, 2015

Organization subpart

No

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

Authorized official

Name

Byron Gladden

Title

Practice Manager

Phone

(336) 907-3006

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Kimberly Renee Shelton, MD

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1649270984
  Medicare reassignment NPD

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512000000000",
    "number": "1609260942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1591 YANCEYVILLE STREET",
            "address_2": "SUITE 200A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056941",
            "telephone_number": "336-907-3006",
            "fax_number": "336-230-1761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1591 YANCEYVILLE STREET",
            "address_2": "SUITE 200A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056941",
            "telephone_number": "336-907-3006",
            "fax_number": "336-663-8421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMA WELLNESS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-25",
        "last_updated": "2017-11-30",
        "status": "A",
        "authorized_official_last_name": "GLADDEN",
        "authorized_official_first_name": "BYRON",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "336-907-3006"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "95-01417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8975633",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arielle Tigney, PHARMD
• Michael Andrew Tillery, PA-C
• Monica Lorraine Tillett, PT, DPT
• William Spencer Tilley Jr., MD
• Shannon Daniel Tillman, SLP
• Kathryn Stewart Timberlake, MD
• Phillip Mark Timcheck, CRNA
• Ashley Wahlfeldt Timmons, NP
• Tims Home Care Agency Inc
• Karen Tinsley

• Internal Medicine Physician in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.