Individual provider Active NPI

Timothy Edward Deonier, SA-C

  • Surgical Assistant
  • Grand Junction, CO
National Provider Identifier
1083009005
Registry record updated Sep 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
15-235 Issued in CO
Practice address
592 Sinatra Way
Grand Junction, CO 81501-6926
Phone
(210) 387-7193
NPI assigned
Apr 6, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 15-235 CO Primary

Addresses

Primary practice location

592 Sinatra Way
Grand Junction, CO 81501-6926

Mailing address

592 Sinatra Way
Grand Junction, CO 81501-6926
Phone (210) 387-7193

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

LicenseStateTypeSpecialty
15-235COMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475020800000",
    "number": "1083009005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "592 SINATRA WAY",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016926",
            "telephone_number": "210-387-7193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "592 SINATRA WAY",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016926",
            "telephone_number": "210-387-7193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEONIER",
        "first_name": "TIMOTHY",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-06",
        "last_updated": "2016-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "CO",
            "license": "15-235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2016; 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.