Active NPI
Timothy Bresee
- Social Worker
- Broomfield, CO
National Provider Identifier
1124546411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- CSW.00991300
- Practice address
- 12564 Big Dry Creek Dr
Broomfield, CO 80020-3801 - Phone
- (303) 439-8957
- NPI assigned
- Sep 6, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | CSW.00991300 | CO | Primary |
Addresses
Primary practice location
12564 Big Dry Creek Dr
Broomfield, CO 80020-3801
Mailing address
12564 Big Dry Creek Dr
Broomfield, CO 80020-3801
Phone (303) 239-8957
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 |
|---|---|---|---|
| CSW.00991300 | CO | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1124546411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12564 BIG DRY CREEK DR",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800203801",
"telephone_number": "303-239-8957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12564 BIG DRY CREEK DR",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800203801",
"telephone_number": "303-439-8957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRESEE",
"first_name": "TIMOTHY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-06",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CO",
"license": "CSW.00991300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.