Timothy Carr Deans
Individual provider Active NPI Registered Dietitian · Supply, NC
NPI 1629926563 · NPPES record last updated Mar 17, 2026
Key facts
- NPI
- 1629926563
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 86108028 (NC)
- Practice address
- 2401 Calvert St SW
Supply, NC 28462-5621 - Phone
- (910) 625-6929
- NPI assigned
- Mar 17, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86108028 | NC | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86108028 | NC | Yes |
Addresses
Primary practice location
2401 Calvert St SW
Supply, NC 28462-5621
Mailing address
2401 Calvert St SW
Supply, NC 28462-5621
Other providers in Supply, NC
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- Mary Rudd Crichton
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- Lauren Deluca
- Jonathan Nicholas Desillier
- Brandon Eric Devito
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- Edward E. Hayes M.D.LLC
All providers in Supply, NC · Registered Dietitian in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.