Individual provider Active NPI

David Paul Timme, PA-C

  • Physician Assistant
  • Harrisburg, PA
National Provider Identifier
1194947218
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA-000886-L Issued in PA
Practice address
1100 S Cameron St
Harrisburg, PA 17104-2547
Phone
(717) 238-7662
Fax
(717) 238-7894
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA-000886-L PA Primary

Addresses

Primary practice location

1100 S Cameron St
Harrisburg, PA 17104-2547

Mailing address

151 Woodside CT
Annville, PA 17003-1950
Phone (717) 867-5015

Other identifiers 1

IdentifierTypeStateIssuer
1056421MedicaidPA

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA-000886-LPAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Affiliated Services, Inc PastSince Jul 16, 1992 Accepting new patients
East Shore Psychiatric Associates PC Past Accepting new patients

Organizations & group practices 2

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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1194947218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 WOODSIDE CT",
            "city": "ANNVILLE",
            "state": "PA",
            "postal_code": "170031950",
            "telephone_number": "717-867-5015",
            "fax_number": "717-238-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S CAMERON ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171042547",
            "telephone_number": "717-238-7662",
            "fax_number": "717-238-7894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMME",
        "first_name": "DAVID",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA-000886-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1056421",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.