NPIMap

Individual provider Active NPI

Timothy Stuart, PA-C

  • Physician Assistant
  • Gaffney, SC
National Provider Identifier
1952558058
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
984 Issued in SC
Practice address
1307 N Logan St
Gaffney, SC 29341-2026
Phone
(864) 488-1333
Fax
(864) 488-3004
NPI assigned
Aug 20, 2008
Last updated
Mar 2, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 984 SC Primary

Addresses

Primary practice location

1307 N Logan St
Gaffney, SC 29341-2026

Mailing address

1307 N Logan St
Gaffney, SC 29341-2026
Phone (864) 488-1333

Other practice location 1

303 W Pine St Ste B
Blacksburg, SC 29702-1549
Phone (864) 839-9082

Other practice location 2

103 Stuard St
Gaffney, SC 29341-1263
Phone (864) 488-9500

Other practice location 3

1314 North Limestone St
Gaffney, SC 29340-4823
Phone (864) 489-3360

Other practice location 4

1506 N Limestone St Ste B
Gaffney, SC 29340-4747
Phone (864) 487-4451

Other identifiers 4

IdentifierTypeStateIssuer
SCE4916084OtherSCMEDICARE PIN
P00911625OtherSCRAILROAD MEDICARE
0512PAMedicaidSC
SCE4916121OtherSCMEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050829000595 SC Practitioner - Physician Assistant 9830120922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee Community Care, LLCGroup PAC ID 6406187855, 3 clinicians

Practice addresses (Care Compare)

1307 N Logan St
Gaffney, SC 29341-2026
Phone 86448813332

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gaffney Emergency Group PC Physician Assistant Past Accepting new patients
SC Cherokee Emergency Physicians Past Accepting new patients
Cherokee Community Care, LLC Past Accepting new patients
Upstate Emergency Service Past Accepting new patients

Organizations & group practices 5

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 5

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": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1952558058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 N LOGAN ST",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293412026",
            "telephone_number": "864-488-1333",
            "fax_number": "864-488-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 N LOGAN ST",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "293412026",
            "telephone_number": "864-488-1333",
            "fax_number": "864-488-3004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 W Pine St Ste B",
            "address_purpose": "LOCATION",
            "city": "Blacksburg",
            "state": "SC",
            "postal_code": "297021549",
            "country_code": "US",
            "telephone_number": "864-839-9082",
            "fax_number": "864-839-3064",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "103 Stuard St",
            "address_purpose": "LOCATION",
            "city": "Gaffney",
            "state": "SC",
            "postal_code": "293411263",
            "country_code": "US",
            "telephone_number": "864-488-9500",
            "fax_number": "864-489-9200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1314 North Limestone St",
            "address_purpose": "LOCATION",
            "city": "Gaffney",
            "state": "SC",
            "postal_code": "293404823",
            "country_code": "US",
            "telephone_number": "864-489-3360",
            "fax_number": "864-488-3744",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1506 N Limestone St Ste B",
            "address_purpose": "LOCATION",
            "city": "Gaffney",
            "state": "SC",
            "postal_code": "293404747",
            "country_code": "US",
            "telephone_number": "864-487-4451",
            "fax_number": "864-487-4788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUART",
        "first_name": "TIMOTHY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-20",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCE4916084",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00911625",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0512PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCE4916121",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaffney, SC

Sources for this page

Verify at the official NPI Registry.