Individual provider Active NPI

Joseph Timgren

  • Athletic Trainer
  • Kalamazoo, MI
National Provider Identifier
1144761370
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2601001587 Issued in MI
Practice address
5048 Coopers Landing Dr
Apt 2B
Kalamazoo, MI 49004-6657
Phone
(952) 797-4718
NPI assigned
Mar 20, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2601001587 MI Primary

Addresses

Primary practice location

5048 Coopers Landing Dr
Apt 2B
Kalamazoo, MI 49004-6657

Mailing address

5048 Coopers Landing Dr
Apt 2B
Kalamazoo, MI 49004-6657
Phone (952) 797-4718

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
2601001587MIMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1144761370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5048 COOPERS LANDING DR",
            "address_2": "APT 2B",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490046657",
            "telephone_number": "952-797-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5048 COOPERS LANDING DR",
            "address_2": "APT 2B",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490046657",
            "telephone_number": "952-797-4718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMGREN",
        "first_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MI",
            "license": "2601001587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.