Tom Patrick Timothy, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9104798 Issued in FL

Practice address

2817 Rock Merritt Ave
Ft Liberty, NC 28308

Phone

(907) 910-0948

Fax

(727) 539-6118

NPI assigned

Jan 29, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1699006718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 BRANDON PARK CIR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335103946",
            "telephone_number": "813-318-1382",
            "fax_number": "727-539-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FT LIBERTY",
            "state": "NC",
            "postal_code": "28308",
            "telephone_number": "907-910-0948",
            "fax_number": "727-539-6118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMOTHY",
        "first_name": "TOM",
        "middle_name": "PATRICK",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-29",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Summers-Johnson
• Lisa Currrence Tapscott, M.A. CCC-SLP
• Sameh Dawoud Tawadrous, DDS
• Anthony John Tesora, PTA
• Laura Marie Thompson
• Daniel Lincoln Torchia, 18D
• Beth Colleen Trucksa, RN
• John Tuepker, D.O
• Marcia Turley
• Matthew Turner

• Physician Assistant in Ft Liberty, NC
• Providers in Ft Liberty, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.