Benson Ellison Lane Timmons IV, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

39341 Issued in NC

Practice address

649 N New Hope Rd
Gastonia, NC 28054-7424

Phone

(704) 866-4005

Fax

(704) 866-0450

NPI assigned

Aug 10, 2005

Last updated

Jun 23, 2020By 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 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Southeastern Plastic Surgery PC

  • Plastic and Reconstructive Surgery Physician
  • Gastonia, NC
  • NPI 1821068891
  Authorized official Same address or phone
• Piedmont Plastic Surgery and Dermatology

  • Dermatology Physician
  • Shelby, NC
  • NPI 1316056104
  NPD (past)

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1962404996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 X RAY DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547488",
            "telephone_number": "704-671-1094",
            "fax_number": "704-671-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 N NEW HOPE RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547424",
            "telephone_number": "704-866-4005",
            "fax_number": "704-866-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMMONS",
        "first_name": "BENSON",
        "middle_name": "ELLISON LANE",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NC",
            "license": "39341",
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NC",
            "license": "39341",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8354X",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "2165882F",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "898354X",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "2165882G",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Kersey Throckmorton, DPM
• Christopher Walser Thrower, PHARMD
• Donald Ray Thrower, RPH
• Christopher Kyle Tietsort, QUALIFIED PROFESSION
• Shanaira Nicole Tigler, FNP-C
• Julie Tina, LCSW
• Caroline Sylvia Tindall, LCSWA
• Lauren Titcher
• TLC Group, LLC
• TLC Telehealth Services, LLC

• Plastic Surgery Physician in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Plastic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.