Tideline Psych PLLC
NPI 1578384301ActiveOrganization· Physician Assistant· Wilmington, NC
Physician Assistant in Wilmington, North Carolina, registered in NPPES in October 2024. The authorized official on file is William Thomas Bunting, Practice Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1578384301 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 23, 2024 |
| Last updated in NPPES | Jun 5, 2026 |
| Certified by provider | Jun 5, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | — |
| Physician Assistant, Medical | 363AM0700X | — | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NC) |
|---|
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