Timothy Shawn Fitzgerald, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

112679 Issued in NC

Practice address

1717 Shipyard Blvd
Suite 350
Wilmington, NC 28403-8023

Phone

(910) 799-0110

Fax

(910) 799-1958

NPI assigned

Aug 9, 2006

Last updated

Jan 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141
• Pender Memorial Hospital Hospital, Burgaw, NC, CCN 341307
• J Arthur Dosher Memorial Hospital Hospital, Southport, NC, CCN 341327

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sfitzgerald@csmos1866.srs-direct.com
• Direct secure messaging: sfitzgerald1245827@direct.novanthealth.org
• Direct secure messaging: timothy.fitzgerald.p1@direct.wilmingtonhealth.nextgenshare.com

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.

• Wilmington Health PLLC

  • Multi-Specialty Clinic/Center
  • Wilmington, NC
  • NPI 1881632339
  Medicare reassignment Care Compare group NPD
• Wilmington ASC LLC

  dba Wilmington Health Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Wilmington, NC
  • NPI 1548456478
  NPD
• Shoreline Physical Therapy, LLC

  dba Shoreline Physical Therapy

  • Physical Therapist
  • Wilmington, NC
  • NPI 1851685010
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• J Arthur Dosher Memorial Hospital

  dba Dosher Wellness Center

  • Rural Health Clinic/Center
  • Southport, NC
  • NPI 1326589649

  Hospital

  Care Compare affiliation
• J. Arthur Dosher Memorial Hospital

  dba Dosher Medical - Oak Island

  • Rural Health Clinic/Center
  • Oak Island, NC
  • NPI 1235405358

  Hospital

  Care Compare affiliation
• J. Arthur Dosher Memorial Hospital

  dba Dosher Medical - Bald Head Island

  • General Practice Physician
  • Bald Head Island, NC
  • NPI 1376961219

  Hospital

  Care Compare affiliation
• J. Arthur Dosher Memorial Hospital

  • Critical Access Hospital
  • Southport, NC
  • NPI 1538260229
  Care Compare affiliation
• J. Arthur Dosher Memorial Hospital

  dba Dosher Medical - Long Beach Road

  • Rural Health Clinic/Center
  • Southport, NC
  • NPI 1568887818

  Hospital

  Care Compare affiliation
• Novant Health New Hanover Regional Medical Center LLC

  dba Novant Health New Hanover Regional Medical Center

  • General Acute Care Hospital
  • Wilmington, NC
  • NPI 1376139139
  Care Compare affiliation
• Pender Memorial Hospital, Incorporated

  dba Novant Health Pender Medical Center

  • Critical Access Hospital
  • Burgaw, NC
  • NPI 1295703130
  Care Compare affiliation
• Pender Memorial Hospital, Incorporated

  dba Novant Health Pender Medical Center

  • Medicare Defined Swing Bed Hospital Unit
  • Burgaw, NC
  • NPI 1780653865
  Care Compare affiliation

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1811907819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR STE 350",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-617-6705",
            "fax_number": "910-431-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 SHIPYARD BLVD",
            "address_2": "SUITE 350",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284038023",
            "telephone_number": "910-799-0110",
            "fax_number": "910-799-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "TIMOTHY",
        "middle_name": "SHAWN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "112679",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "112679",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "112679",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0197953",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "30772",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8930772",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0928879",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKMANS COMP",
            "identifier": "561926376",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "047501023",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00023289",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Fisher, LPA
• Lindsay Fisher, MA CCC-SCP
• Lynell Brooke Fisher, PTA
• Michael John Fisher, MD
• Michael Fitzgerald
• Maegan Rose Fitzgibbon, LCSWA
• Jean Mary Fitzgibbons
• Easton Victoria Fitzpatrick
• Cynthia R Fitzsimmons, PSY.D.
• Five Star Rehabilitation and Wellness Services, LLC (Ageility Physical Therapy Solutions at Wilmington)

• Physician Assistant in Wilmington, NC
• Providers in Wilmington, 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 Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.