DR. TIMOTHY MENZ (NPI# 1013296730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013296730 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY MENZ |
| Credential | MD |
| Practice Address |
2711 Randolph Rd Ste 301 Charlotte NC 28207-2027 |
| Practice Telephone | 7043165060 |
| Practice Fax Number | 7043165069 |
| Mailing Telephone | 7043165060 |
| Mailing Fax Number | 7043165069 |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2020-10-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
2018-01919 | NC | Allopathic & Osteopathic Physicians |
| N | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
MD 14898 | RI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | FM5102570 | 01 | |
| NC | MENZY3045 | 05 | |
| NC | NORTH CAROLINA MEDICAL LICENSE | 2018-01919 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 593 Eddy St, Providence, RI 029034923 | 4014448306 | |
| 10030 Gilead Rd Ste 344, Huntersville, NC 280787545 | 7043165060 | 7043165069 |
| 530 Corporate Cir Ste 200, Salisbury, NC 281478074 | 7043165060 | 7043165069 |
| Street Address |
2711 RANDOLPH RD STE 301 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28207-2027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013560739 | Louis Roncaglione | Dentist | 8815 Christenbury Pkway, Concord, NC 28207 | 2019-07-22 |
| 1619430014 | Khrystyna Levytska | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Ob/gyn, 1350 S. Kings Dr., Charlotte, NC 28207 | 2019-04-11 |
| 1649743584 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 1005 South Kings Drive, Charlotte, NC 28207 | 2019-01-03 |
| 1023584489 | Herron and Smith Associates, Pllc | Dentist | 135 Perrin Place, Suite 100, Charlotte, NC 28207 | 2018-10-23 |
| 1588161640 | Lauren Mogk | Student in an Organized Health Care Education/Training Program | Myers Park Clinical Internal Medicine, 1350 S. Kings Dr., 3rd Floor, Charlotte, NC 28207 | 2018-04-06 |
| 1518462241 | Sarah Hollyn Carlock | Student in an Organized Health Care Education/Training Program | Myers Park Clinic Internal Medicine, 1350 S Kings Dr, 3rd Floor, Charlotte, NC 28207 | 2018-03-26 |
| 1083118178 | Claire Milam | Student in an Organized Health Care Education/Training Program | Cmc/department of Emergency Medicine, 100 Blythe Blvd, Charlotte, NC 28207 | 2018-03-22 |
| 1811422256 | Complete Care At Dartmouth LLC | Skilled Nursing Facility | 300 Province Road, Charlotte, NC 28207 | 2017-04-24 |
| 1063945467 | Kaitlyn O'keefe | Internal Medicine | 1350 S. Kings Dr., 3rd Floor, Myers Park Clinic Internal Medicine, Charlotte, NC 28207 | 2017-04-04 |
| 1811432024 | Advanced Prosthetics of Easley, Inc | Durable Medical Equipment & Medical Supplies | 2310 Randolph Rd Ste A, Charlotte, NC 28207 | 2016-12-23 |
| Find all providers in zip 28207 | ||||
| Taxonomy Code | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912286410 | Carolinas Medical Center-northeast | Pediatrics | 101 East W T Harris Blvd, Bldg 3000, Suite 3301e, Charlotte, NC 28262-7000 | 2011-08-15 |
| 1013453604 | Novant Medical Group, Inc. | Pediatrics | 11840 Southmore Dr, Suite 200, Charlotte, NC 28277-4466 | 2017-01-06 |
| 1770979353 | Novant Medical Group, Inc. | Pediatrics | 13557 Steelecroft Pkwy, Suite 2200, Charlotte, NC 28278-0057 | 2015-04-10 |
| 1164705653 | Novant Medical Group Inc | Pediatrics | 16139 Lancaster Hwy, Suite 110, Charlotte, NC 28277-2033 | 2011-09-21 |
| 1194911123 | Jason Dranove | Pediatrics | 1001 Blythe Blvd, Medical Center Plaza Suite 200, Charlotte, NC 28203-5866 | 2007-09-24 |
| 1386851590 | Melanie K Rhue | Pediatrics | 2711 Randolph Rd, Suite 301, Charlotte, NC 28207-2034 | 2007-05-17 |
| 1740312909 | Ameesh Shah | Pediatrics | 1001 Blythe Blvd, Medical Center Plaza Suite 200, Charlotte, NC 28203-5866 | 2007-03-12 |
| 1003966185 | Novant Medical Group, Inc. | Pediatrics | 2711 Randolph Rd, Suite 301, Charlotte, NC 28207-2027 | 2007-01-11 |
| 1205910734 | Tiffany Linville | Pediatrics | 1001 Blythe Blvd, Medical Center Plaza Suite 200, Charlotte, NC 28203-5866 | 2006-10-24 |
| 1568552206 | Vani Gopalareddy | Pediatrics | 1350 S Kings Dr, Charlotte, NC 28207-2134 | 2006-10-13 |
| Find all providers in CHARLOTTE | ||||
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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.