Individual provider Active NPI

Katrina M Timson, MD

  • Family Medicine Physician
  • Newark, OH
National Provider Identifier
1144228131
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-059016 Issued in OH
Practice address
399 E Main St
Newark, OH 43055-6516
Phone
(220) 564-1846
Fax
(220) 564-1847
NPI assigned
Jul 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-059016 OH Primary

Addresses

Primary practice location

399 E Main St
Newark, OH 43055-6516

Mailing address

399 E Main St
Newark, OH 43055-6516
Phone (220) 564-1846

Other identifiers 1

IdentifierTypeStateIssuer
0829241MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ktimson14436@lickingmemorial.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080331000181 OH Practitioner - Family Practice 5799861894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
JC Edwards School of Medicine, Marshall University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

120 McMillen Dr
Newark, OH 43055-1809
Phone (220) 564-4806

36 McMillen Dr
Newark, OH 43055-1809
Phone (220) 564-4270

399 E Main St
Newark, OH 43055-6516
Phone (220) 564-1846

88 McMillen Dr
Newark, OH 43055-1809
Phone (220) 564-4270

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.98 of 100Reported as group
Quality
75.66
Promoting interoperability
100
Improvement activities
40
Cost
75.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-059016OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Licking Memorial Health Professionals Family Medicine CurrentSince Feb 1, 1995 Accepting new patients
Licking Memorial Hospital Current Accepting new patients
Licking Memorial Professional Corporation CurrentSince Feb 1, 1995 Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients
Licking Memorial Professional Corp. Past Accepting new patients

Locations

1320 W Main St
Newark, OH 43055
Phone (740) 348-4151

120 McMillen Dr
Newark, OH 43055
Phone (220) 564-4806

399 E Main St
Newark, OH 43055
Phone (220) 564-1846

Organizations & group practices 5

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 2

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1144228131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 E MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430556516",
            "telephone_number": "220-564-1846",
            "fax_number": "220-564-1847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430556516",
            "telephone_number": "220-564-1846",
            "fax_number": "220-564-1847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMSON",
        "first_name": "KATRINA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-13",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-059016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0829241",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktimson14436@lickingmemorial.medicity.net",
            "affiliation": "N",
            "address_1": "399 E Main St",
            "city": "Newark",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430556516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.