Tim Ioannides MD LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

TIM IOANNIDES MD LLC

Doing business as

Treasure Coast Dermatology

Practice address

140 SW Chamber CT
Suite 200
Port St Lucie, FL 34986-3414

Phone

(772) 878-3376

Fax

(772) 879-9970

NPI assigned

May 2, 2006

Last updated

Dec 22, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tim Ioannides, MDNPI 1952369779

Title

Owner

Phone

(772) 878-3376

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Treasure Coast Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tim Ioannides, MD

  • Dermatology Physician
  • Port Saint Lucie, FL
  • NPI 1952369779
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324512000000",
    "number": "1659339497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SW CHAMBER CT",
            "address_2": "SUITE 200",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863414",
            "telephone_number": "772-878-3376",
            "fax_number": "772-879-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SW CHAMBER CT",
            "address_2": "SUITE 200",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863414",
            "telephone_number": "772-878-3376",
            "fax_number": "772-879-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIM IOANNIDES MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2011-12-22",
        "status": "A",
        "authorized_official_last_name": "IOANNIDES",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-878-3376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "74907",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA2154",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Treasure Coast Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thorough Med LLC
• Thorough Med LLC
• Thrive Rehab LLC
• Tiffany Emergency Physicians
• Tiffany Hall Nursing & Rehab Center
• Alice Times
• Mark D Times
• Sheryl Timol, APRN
• Timothy S Salib DMD PA (Veranda Family Dentistry)
• James Manley Tinsley Jr., D.D.S.

• Dermatology Physician in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.