Timothy Paul Degeorge, PT, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40128 Issued in CA

Practice address

4751 Fair Oaks Blvd
Carmichael, CA 95608-6018

Phone

(530) 515-6911

NPI assigned

Jun 12, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1144601485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4751 FAIR OAKS BLVD",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956086018",
            "telephone_number": "530-515-6911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4751 FAIR OAKS BLVD",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956086018",
            "telephone_number": "530-515-6911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGEORGE",
        "first_name": "TIMOTHY",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PT, MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-12",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "40128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6600 Bruceville Rd",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958234671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelsey Carolyn Dean
• Rebecca M Dean, CNS
• James Matt Deen, MD
• Deep Insight Psychology, Inc
• Loreta Defazio, LVN
• Qurieno Deguchy Jr., MD
• David Damian Deluca
• Lindsey Demetral, D.O.
• Michael Karsten Dengel, M.D.
• Carla Denner, MSW

• Physical Therapist in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.

Verify at the official NPI Registry.