=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508710328
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TIMOTHY CHESTER SMITH FNP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2026
-----------------------------------------------------
Last Update Date | 02/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 610 N FAYETTEVILLE ST
-----------------------------------------------------
City | ASHEBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27203-4670
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-308-2560
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 193
-----------------------------------------------------
City | SHALLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28459-0193
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-880-9791
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208VP0000X
-----------------------------------------------------
Taxonomy Name | Pain Medicine Physician
-----------------------------------------------------
License Number | 1295362002
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------