Charley Tyre, NP-C is a medicare enrolled "Nurse Practitioner - Adult Health" in Grimesland, North Carolina. She graduated from nursing school in 2013 and has 11 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Outer Banks Professional Services, Llc and her current practice location is
2627 Winding Cv, Grimesland, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(252) 217-8288.
Charley Tyre is licensed to practice in North Carolina (license number 5006569) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1609204585.
Provider's Profile
| Full Name | Charley Tyre |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 11 Years |
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| Location | 2627 Winding Cv, Grimesland, North Carolina |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Charley Tyre graduated from nursing school in 2013
NPI Data:
- NPI Number: 1609204585
- Provider Enumeration Date: 10/31/2013
- Last Update Date: 03/09/2022
Medicare PECOS Information:
- PECOS PAC ID: 4688801699
- Enrollment ID: I20131219001282
Medical Identifiers
Medical identifiers for Charley Tyre such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609204585 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LA2200X | Nurse Practitioner - Adult Health | 5006569 (North Carolina) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Outer Banks Professional Services, Llc | 3173652096 | 83 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Charley Tyre allows following entities to bill medicare on her behalf.
| Entity Name | Vidant Medical Group Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477648731
PECOS PAC ID: 0345343893
Enrollment ID: O20070321000445 |
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| Entity Name | Outer Banks Professional Services, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1891050357
PECOS PAC ID: 3173652096
Enrollment ID: O20100602000156 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Charley Tyre is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Charley Tyre, NP-C
Po Box 333,
Manns Harbor, NC 27953-0333
Ph: () - | Charley Tyre, NP-C
2627 Winding Cv,
Grimesland, NC 27837-8612
Ph: (252) 217-8288 |
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