Individual provider Active NPI

Timothy Wayne Brotherton, M,D,

  • Hematology & Oncology Physician
  • Danville, VA
National Provider Identifier
1013919398
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
0101046457 Issued in VA
Practice address
125 Executive Dr
Ste J
Danville, VA 24541-4155
Phone
(434) 793-0044
Fax
(434) 792-8864
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 0101046457 VA Primary

Addresses

Primary practice location

125 Executive Dr
Ste J
Danville, VA 24541-4155

Mailing address

125 Executive Dr
Ste J
Danville, VA 24541-4155
Phone (434) 793-0044

Other identifiers 1

IdentifierTypeStateIssuer
6060641MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0101046457VAMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Danville Hematology & Oncology, Inc. Hematology & Oncology Current Accepting new patients
Danville Physician Practices LLC Past Accepting new patients

Locations

125 Executive Dr
Ste J
Danville, VA 24541
Phone (434) 793-0044

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1013919398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 EXECUTIVE DR",
            "address_2": "STE J",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414155",
            "telephone_number": "434-793-0044",
            "fax_number": "434-792-8864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 EXECUTIVE DR",
            "address_2": "STE J",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245414155",
            "telephone_number": "434-793-0044",
            "fax_number": "434-792-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTHERTON",
        "first_name": "TIMOTHY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M,D,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "VA",
            "license": "0101046457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6060641",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.