Individual provider Active NPI

Edmund Joseph Timpano, MD

  • Emergency Medicine Physician
  • Sevierville, TN
National Provider Identifier
1154663821
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
64643 Issued in TN
Practice address
742 Middle Creek Rd
Sevierville, TN 37862-5019
Phone
(865) 466-7000
NPI assigned
Mar 20, 2013
Last updated
Jun 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D0082121 MD
Emergency Medicine Physician 207P00000X 64643 TN Primary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X D0082121 MD

Addresses

Primary practice location

742 Middle Creek Rd
Sevierville, TN 37862-5019

Mailing address

1602 Starmont TRL
Knoxville, TN 37909-1827
Phone (315) 404-8882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20211230001200 TN Practitioner - Emergency Medicine 3577704923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York Medical College, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

742 Middle Creek Rd
Sevierville, TN 37862-5019
Phone (865) 908-3608

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0082121MDMDEmergency Medicine Physician
64643TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Dec 1, 2021 Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1154663821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 STARMONT TRL",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091827",
            "telephone_number": "315-404-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 MIDDLE CREEK RD",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378625019",
            "telephone_number": "865-466-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMPANO",
        "first_name": "EDMUND",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0082121",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "64643",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MD",
            "license": "D0082121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sevierville, TN

Sources for this page

Verify at the official NPI Registry.