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

LicenseStateTypeSpecialty
86108028NCMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

All providers in Supply, NC · Registered Dietitian in North Carolina

Sources for this page

Verify at the official NPI Registry.