Tim Davis Wax, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

33929 Issued in NC

Practice address

105 W 4TH St Ste 600
Winston Salem, NC 27101-3816

Phone

(336) 306-5777

Fax

(336) 999-8889

NPI assigned

Aug 22, 2005

Last updated

Oct 3, 2022By 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 1

Addresses

Other identifiers 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

University of Mississippi School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Digestive Health Associates PAGroup PAC ID 1951209790, 45 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Carolina Digestive Health Associates, PA

  • Gastroenterology Physician
  • Charlotte, NC
  • NPI 1124052444
  Medicare reassignment Care Compare group NPD
• Cabarrus Gastroenterology Associates, PLLC

  dba Northeast Digestive Health Center

  • Gastroenterology Physician
  • Concord, NC
  • NPI 1780790592
  Medicare reassignment NPD
• Cabarrus Pathology Associates PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Concord, NC
  • NPI 1538131800
  Medicare reassignment NPD
• Pathologists Diagnostic Laboratory PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Winston Salem, NC
  • NPI 1003883877
  Medicare reassignment NPD
• Cabarrus Gastroenterology Associates, PLLC

  dba Northeast Digestive Health Center

  • Gastroenterology Physician
  • Salisbury, NC
  • NPI 1154008142
  NPD
• Cabarrus Gastroenterology Associates, PLLC

  dba Northeast Digestive Poplar Tent

  • Gastroenterology Physician
  • Concord, NC
  • NPI 1417514522
  NPD
• Pathologists Diagnostic Laboratory PA

  • Clinical Medical Laboratory
  • Winston Salem, NC
  • NPI 1437424975
  NPD
• Carolina Digestive Health Associates, PA

  dba Carolina Digestive Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Charlotte, NC
  • NPI 1063584415
  NPD (past)
• Carolinas Medical Center-Northeast

  dba Kannapolis Internal Medicine

  • Internal Medicine Physician
  • Kannapolis, NC
  • NPI 1689620957
  NPD (past)
• Progressive Pathology LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Boone, NC
  • NPI 1861431868
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1881686178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30369",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271300369",
            "telephone_number": "336-999-8888",
            "fax_number": "336-999-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W 4TH ST STE 600",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013816",
            "telephone_number": "336-306-5777",
            "fax_number": "336-999-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAX",
        "first_name": "TIM",
        "middle_name": "DAVIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "33929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "86073",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "220016574",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8986073",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashlyn Makenzie Watts, OTR/L
• David Ashworth Watts, MD
• Tamika Watts
• Molly Jordan Waugh
• Waves of Hope, LLC
• Michael Cole Way, PT, ATC
• Victoria Way
• Lisa Maria Waye, DNP PMHNP-BC
• Wayne Cannon PT and Associates
• Wayne M. Sotile, PH.D. (Sotile Psychological Associates, PLLC)

• Anatomic Pathology & Clinical Pathology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Anatomic Pathology & Clinical Pathology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.