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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
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 |
Street Address |
123 SULLY ST |
City | GOOSE CREEK |
State | SC |
Zip Code | 29445-5447 |
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 |
Find all providers in zip 29445 |
Taxonomy Code | 1710I1002X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Specialization | Independent Duty Corpsman |
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] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932281102 | Kelly Lynn Youngerman | Military Health Care Provider | 110 Nnptc Cir, Goose Creek, SC 29445-6314 | 2006-10-19 |
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 |
Find all providers with the same taxonomy |
City | GOOSE CREEK |
Zip Code | 29445 |
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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.