NPIMap

Individual provider Active NPI

Timothy S Gormley, MD

  • Diagnostic Radiology Physician
  • Richland, WA
National Provider Identifier
1043200686
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD035310 Issued in DC
Practice address
888 Swift Blvd
Richland, WA 99352-3514
Phone
(509) 946-4611
NPI assigned
Oct 25, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD035310 DC Primary

Addresses

Primary practice location

888 Swift Blvd
Richland, WA 99352-3514

Mailing address

MSC 1023
P.O. Box 2300
Spokane, WA 99210
Phone (509) 946-4611

Other identifiers 2

IdentifierTypeStateIssuer
8487944MedicaidWA
274577MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MT, OR3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20070828000630 WA Practitioner - Diagnostic Radiology 5799710158 Reassigns benefits to 5 organizations
I20181011000970 MT Practitioner - Diagnostic Radiology 5799710158 Reassigns benefits to 3 organizations
I20260513002224 OR Practitioner - Diagnostic Radiology 5799710158 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Pennsylvania, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integra Imaging PSGroup PAC ID 1355593062, 126 clinicians
Inland Imaging LLCGroup PAC ID 6608763016, 128 clinicians
Inland Imaging Associates PSGroup PAC ID 7810327210, 124 clinicians

Practice addresses (Care Compare)

101 W 8TH Ave
Spokane, WA 99204-2307
Phone (509) 363-7745

2740 S Ave W
Suite 103
Missoula, MT 59804-5137
Phone (509) 363-7788

2801 St Anthony Way
Pendleton, OR 97801-3800
Phone (541) 276-5121

2827 Fort Missoula Rd
Missoula, MT 59804-7408
Phone (509) 363-7788

525 S Cowley St
Spokane, WA 99202-1381
Phone (509) 747-4455

801 S Stevens St
Spokane, WA 99204-2654
Phone (509) 363-7788

Hospital & facility affiliations

  • Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058
  • St Anthony Hospital Hospital, Pendleton, OR, CCN 381319
  • St. Patrick Hospital Hospital, Missoula, MT, CCN 270014
  • Prosser Memorial Hospital Hospital, Prosser, WA, CCN 501312
  • Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD035310DCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Center Radiology PC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 10

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1043200686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MSC 1023",
            "address_2": "P.O. BOX 2300",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99210",
            "telephone_number": "509-946-4611",
            "fax_number": "509-943-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 SWIFT BLVD",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523514",
            "telephone_number": "509-946-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMLEY",
        "first_name": "TIMOTHY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "DC",
            "license": "MD035310",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8487944",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274577",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.