Active NPI
Timothy Shawn Dehart, CSFA
- Surgical Assistant
- Leander, TX
National Provider Identifier
1043401292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 87458
- Practice address
- 204 Deercreek Lane
Suite 1550
Leander, TX 78641 - Phone
- (512) 557-6433
- Fax
- (512) 337-3750
- NPI assigned
- Aug 5, 2007
- Last updated
- Nov 12, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 87458 | TX | Primary |
| Surgical Technologist | 246ZS0410X | 87458 | TX |
Addresses
Primary practice location
204 Deercreek Lane
Suite 1550
Leander, TX 78641
Mailing address
204 Deercreek LN
Leander, TX 78641-7819
Phone (512) 557-6433
Other names 1
- Mr. Timothy Shawn Dehart
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 87458 | TX | MD | Surgical Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Professional First Assistance,LLC | Surgical Assistant | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Gulf Coast Surgical Assistants LCC
- Surgical Assistant
- Leander, TX
- NPI 1104340058
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447286400000",
"number": "1043401292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 DEERCREEK LN",
"city": "LEANDER",
"state": "TX",
"postal_code": "786417819",
"telephone_number": "512-557-6433",
"fax_number": "512-337-3750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 DEERCREEK LANE",
"address_2": "SUITE 1550",
"city": "LEANDER",
"state": "TX",
"postal_code": "78641",
"telephone_number": "512-557-6433",
"fax_number": "512-337-3750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEHART",
"first_name": "TIMOTHY",
"middle_name": "SHAWN",
"name_prefix": "Mr.",
"credential": "CSFA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-05",
"last_updated": "2015-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "TX",
"license": "87458",
"primary": true
},
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": "TX",
"license": "87458",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TIMOTHY",
"last_name": "DEHART",
"middle_name": "SHAWN",
"prefix": "MR.",
"credential": "CERTIFIED FIRST ASSI",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Leander, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.