Active NPI
Timothy John Bauer, EMT B
- Other Technician
- Tinley Park, IL
National Provider Identifier
1174790620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 16243 Bormet Dr
Tinley Park, IL 60477 - Phone
- (231) 445-1073
- NPI assigned
- May 14, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | |||
| Other Technician | 247200000X | Primary |
Addresses
Primary practice location
16243 Bormet Dr
Tinley Park, IL 60477
Mailing address
16243 Bormet Dr
Tinley Park, IL 60477
Phone (231) 445-1073
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
- Credentials
- Emergency Medical Technician
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210723200000",
"number": "1174790620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16243 BORMET DR",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "60477",
"telephone_number": "231-445-1073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16243 BORMET DR",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "60477",
"telephone_number": "231-445-1073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUER",
"first_name": "TIMOTHY",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "EMT B",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-14",
"last_updated": "2008-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": null,
"license": null,
"primary": false
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinley Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.