MR. TIMOTHY MACON


Address: 123 Sully St, Goose Creek, SC 29445-5447
Phone: 8437970003

MR. TIMOTHY MACON (NPI# 1164499513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164499513
Entity Type Individual
Full Name MR. TIMOTHY MACON
Credential SFIDC
Practice Address 123 Sully St
Goose Creek
SC 29445-5447
Practice Telephone 8437970003
Mailing Telephone 8437970003
Enumeration Date 2006-03-03
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1002X Military Health Care Provider
Specialization: Independent Duty Corpsman
Other Service Providers

Other Providers TIMOTHY MACON

NPI Name Taxonomy Address Enumeration
1679561443 Timothy Donald Macon Internal Medicine 780 N Gavord Rd, Sterling, MI 48659-9703 2005-10-06
1184113748 Timothy Macon Physical Therapy Assistant 6200 Oregon Ave Nw, Washington, DC 20015-1543 2018-05-08

Office Location

Street Address 123 SULLY ST
City GOOSE CREEK
State SC
Zip Code 29445-5447

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1790309953 Auriel Mcconnell Home Health 616 One Mans Court, Mount Pleasant, SC 29445 2020-06-03
1215594023 Tanova Cornise Robinson Counselor 96 Wisteria Road, Goose Creek, SC 29445 2019-05-28
1417421777 Debra Liana Kerness Social Worker 100-a Central Avenue, Suite 203, Goose Creek, SC 29445 2019-01-18
1043663503 Aimee Nehiley Dentist 615 Saint James Ave, Goose Creek, SC 29445 2016-07-20
1881057032 Eddie Emanuel Nance Family Medicine 110 Naval Nuclear Power Training Command Cir, Goose Creek, SC 29445 2016-04-04
1295195188 Dental Professionals of South Carolina, PC Dentist 615 St. James Ave, Goose Creek, SC 29445 2016-03-04
1144603622 Laryssa Smith Pharmacist 215 St. James Ave, Goose Creek, SC 29445 2015-07-02
1730439126 O'stacia Williamson Pharmacist 1316 Redbank Rd, 9, Goose Creek, SC 29445 2012-09-13
1164771275 Mary Ashley Watts Pharmacist 431 B St James Ave Suite I, Goose Creek, SC 29445 2012-09-05
1598048860 Brianne Michele Terry Pharmacist 142 East Saint James Ave, Goose Creek, SC 29445 2011-09-23
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Taxonomy Information

Taxonomy Code 1710I1002X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Corpsman

Taxonomy Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.
Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1932281102 Kelly Lynn Youngerman Military Health Care Provider 110 Nnptc Cir, Goose Creek, SC 29445-6314 2006-10-19

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1346619558 Matthew Shaun Woodruff Military Health Care Provider Post Office Box 66038, Marine Aircraft Group 31, Beaufort, SC 29904-6038 2015-09-17
1700144821 Joshua William Crum Military Health Care Provider 7 Saddlemount Ln, Simpsonville, SC 29680-7056 2012-04-26
1114295052 Juan Camachoaclderon Military Health Care Provider 204 Maplewood Ridge, Summerville, SC 29483 2011-12-07
1467783506 Dennis Jason Green Military Health Care Provider 1050 Remount Rd, North Charleston, SC 29406-3544 2010-01-28
1184827941 Matthew Barnhart Military Health Care Provider Mcas Branch Health Clinic, Beaufort, SC 29904-5020 2007-06-08
1861461667 Cheryl R Murphy Military Health Care Provider 669 Blvd De France, Branch Health Clinic, Parris Island, SC 29905-9501 2006-03-15
1730484486 Gerald Dickson Ramones Military Health Care Provider 1 Pinckney Blvd, Mcrd Parris Island, Bhc Parris Island, Beaufort, SC 29902-6122 2011-01-11
1194999185 Ernst Schettini Military Health Care Provider 1 Pinckney Blvd, Beaufort, SC 29902-6122 2008-04-22
1144408501 Matthew David Hall Military Health Care Provider 1 Pinckney Blvd, Beaufort, SC 29902-6122 2008-02-07
1588690465 Michael Owen Congdon Military Health Care Provider 1 Pinckney Blvd, Beaufort, SC 29902-6122 2006-06-23
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Competitor

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City GOOSE CREEK
Zip Code 29445

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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