MEDICARE: MRS. NIKOL DEEM TIMMONS PHYSICIAN ASSISTANT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	101627	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	Q01233714	OTHER	NC	RAILROADMEDICARE
5	N1267048	OTHER	NC	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	7469057	OTHER	NC	CIGNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	19TG1	OTHER	NC	BCBSNC

General Provider Information

NPI Number	:	1194801001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NIKOL DEEM TIMMONS PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	PO BOX 360
Second Line	:
City	:	SYLVA
State	:	NC
Zip	:	28779-0360
Country	:	US
Telephone Number	:	888-339-6065
Fax Number	:	828-538-4441

Provider Business Practice Location Address
First Line	:	6051 TYVOLA GLEN CIR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-6431
Country	:	US
Telephone Number	:	704-774-6569
Fax Number	:	855-308-2340

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	01/26/2026

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Directions to “ MRS. NIKOL DEEM TIMMONS PHYSICIAN ASSISTANT” Practice Location

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