NPIMap

Organization Active NPI

Timothy R. Driver, MD P.C.

  • Clinic/Center
  • Medford, OR
National Provider Identifier
1164656948
Registry record updated May 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MD10723 Issued in OR
Legal business name
TIMOTHY R. DRIVER, MD P.C.
Practice address
2900 Doctors Park Dr
Suite 100
Medford, OR 97504-8198
Phone
(541) 772-6600
Fax
(541) 779-1266
NPI assigned
May 8, 2009
Last updated
May 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2009

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

Authorized official

Name
Dr. Timothy Robert Driver, M.D.
Title
Owner
Phone
(541) 772-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MD10723 OR Primary

Addresses

Primary practice location

2900 Doctors Park Dr
Suite 100
Medford, OR 97504-8198

Mailing address

2900 Doctors Park Dr
Suite 100
Medford, OR 97504-8198
Phone (541) 772-6600

Other identifiers 2

IdentifierTypeStateIssuer
262725MedicaidOR
001930003OtherORBCBS PIN

National Provider Directory

National Provider Directory

Locations

2900 Doctors Park Dr
Ste 1
Medford, OR 97504
Phone (541) 772-6600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241740800000",
    "number": "1164656948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 DOCTORS PARK DR",
            "address_2": "SUITE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048198",
            "telephone_number": "541-772-6600",
            "fax_number": "541-779-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 DOCTORS PARK DR",
            "address_2": "SUITE 100",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048198",
            "telephone_number": "541-772-6600",
            "fax_number": "541-779-1266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY R. DRIVER, MD P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-08",
        "last_updated": "2009-05-08",
        "status": "A",
        "authorized_official_last_name": "DRIVER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-772-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OR",
            "license": "MD10723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262725",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "001930003",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2009; 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.