Active NPI
Emily Timm
- Registered Dietitian
- Davenport, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 110591
- Practice address
- 630 E 4TH St Ste a
Davenport, IA 52801-1713 - Phone
- (309) 721-5441
- NPI assigned
- Feb 12, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 110591 | IA | Primary |
Addresses
Primary practice location
630 E 4TH St Ste a
Davenport, IA 52801-1713
Mailing address
630 E 4TH St Ste a
Davenport, IA 52801-1713
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110591 | IA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Current | Accepting new patients |
Locations
4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872
515 S Flower St
#1015
Los Angeles, CA 90071
401 N Michigan Ave
Ste 1200
Chicago, IL 60611
Phone (224) 496-6940
500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000
3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652313600000",
"number": "1154076701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 E 4TH ST STE A",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528011713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 E 4TH ST STE A",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528011713",
"telephone_number": "309-721-5441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIMM",
"first_name": "EMILY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-12",
"last_updated": "2022-05-12",
"certification_date": "2022-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IA",
"license": "110591",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.