Individual provider Active NPI

Mary Kaitlin Timney, DO

  • Family Medicine Physician
  • Gallipolis, OH
National Provider Identifier
1154068583
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.017983 Issued in OH
Practice address
100 Jackson Pike
Gallipolis, OH 45631-1560
Phone
(740) 446-5739
NPI assigned
May 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 34.017983 OH Primary
Family Medicine Physician 207Q00000X 4416 WV

Addresses

Primary practice location

100 Jackson Pike
Gallipolis, OH 45631-1560

Mailing address

100 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5739

Other identifiers 1

IdentifierTypeStateIssuer
0017815MedicaidOH

Other names 1

  • Kaitlin Vanhooser Former name

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
I20250830000696 OH Practitioner - Family Practice 7911387212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holzer Clinic LLCGroup PAC ID 5890606008, 266 clinicians

Practice addresses (Care Compare)

100 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 446-5050

Hospital & facility affiliations

  • Holzer Medical Center Hospital, Gallipolis, OH, CCN 360054
  • Holzer Medical Center Jackson Hospital, Jackson, OH, CCN 361320

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4416WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Holzer Clinic, LLC CurrentSince Jul 14, 2025 Accepting new patients
I Path LLC Current Accepting new patients
Holzer Hospital Foundation Past Accepting new patients

Locations

100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050

500 Burlington Rd
Jackson, OH 45640
Phone (740) 288-4625

Organizations & group practices 3

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": "1652745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1154068583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-446-5739",
            "fax_number": "740-446-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-446-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMNEY",
        "first_name": "MARY",
        "middle_name": "KAITLIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-17",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.017983",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "4416",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017815",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "VANHOOSER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gallipolis, OH

Sources for this page

Verify at the official NPI Registry.