Individual provider Active NPI

Timothy Boyd, PA-C

  • Physician Assistant
  • Abingdon, VA
National Provider Identifier
1639935406
Registry record updated Nov 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110010019 Issued in VA
Practice address
24530 Falcon Place Blvd Ste 100
Abingdon, VA 24211-7665
Phone
(276) 619-0075
NPI assigned
Feb 28, 2024
Last updated
Nov 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110010019 VA Primary

Addresses

Primary practice location

24530 Falcon Place Blvd Ste 100
Abingdon, VA 24211-7665

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

245 Medical Park Dr Ste C
Marion, VA 24354-1100
Phone (276) 378-3300

Other practice location 2

344 Overlook Dr Ste 200
Lebanon, VA 24266-3436
Phone (276) 883-5900

Other practice location 3

601 Commonwealth Dr
Norton, VA 24273-4053
Phone (276) 679-6028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240613002807 VA Practitioner - Physician Assistant 7416490834 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
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)

1990 Holton Ave E
Big Stone Gap, VA 24219-3350
Phone (423) 230-8200

24530 Falcon Place Blvd
Abingdon, VA 24211-7665

601 Commonwealth Dr
Norton, VA 24273-4053
Phone (276) 679-6028

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0110010019VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Nov 1, 2024 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Nov 1, 2024 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Nov 1, 2024 Accepting new patients

Locations

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

24530 Falcon Place Blvd
Ste 100
Abingdon, VA 24211
Phone (276) 619-0075

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

391 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-4406

1990 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111

344 Overlook Dr
Ste 200
Lebanon, VA 24266
Phone (276) 883-5900

245 Medical Park Dr
Ste C
Marion, VA 24354
Phone (276) 378-1000

601 Commonwealth Dr
Norton, VA 24273
Phone (276) 679-5880

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732752000000",
    "number": "1639935406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111",
            "fax_number": "423-282-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24530 FALCON PLACE BLVD STE 100",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242117665",
            "telephone_number": "276-619-0075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Medical Park Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "VA",
            "postal_code": "243541100",
            "country_code": "US",
            "telephone_number": "276-378-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "344 Overlook Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "VA",
            "postal_code": "242663436",
            "country_code": "US",
            "telephone_number": "276-883-5900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Commonwealth Dr",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242734053",
            "country_code": "US",
            "telephone_number": "276-679-6028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYD",
        "first_name": "TIMOTHY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-28",
        "last_updated": "2024-11-28",
        "certification_date": "2024-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110010019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

Verify at the official NPI Registry.