Timothy A Diller, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301044283 Issued in MI

Practice address

1400 Braden St
Emergency Dept
Jacksonville, AR 72076-3721

Phone

(501) 985-7000

NPI assigned

Apr 10, 2006

Last updated

Jun 19, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Arkansas Health Group

  dba Arkansas Vascular

  • Vascular Surgery Physician
  • Little Rock, AR
  • NPI 1346317476
  NPD (past)
• Arkansas Health Group

  dba Baptist Health Surgical Clinic-Stuttgart

  • Surgery Physician
  • Stuttgart, AR
  • NPI 1952840555
  NPD (past)
• Jacksonville Emergency Medicine LLC

  • Emergency Medicine Physician
  • Jacksonville, AR
  • NPI 1093044166
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1205899481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3925",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711333925",
            "telephone_number": "800-684-0052",
            "fax_number": "405-844-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 BRADEN ST",
            "address_2": "EMERGENCY DEPT",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720763721",
            "telephone_number": "501-985-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DILLER",
        "first_name": "TIMOTHY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301044283",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AR",
            "license": "T2007-006",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ordrey L Denton
• Jasmine Desai, PHARM.D.
• Peyton Nicole Diaz, M.A., CCC-SLP
• Amanda Katherine Diehl, LMSW
• Brandy Dillard
• Eric Dillinger, LPC
• Michael Dillon, LPC
• Cassidi Loraine Dion
• Nicholas Dobbs, PT, DPT
• Doctors Hearing Center LLC II (Doctors Testing Center LLC II)

• Surgery Physician in Jacksonville, AR
• Providers in Jacksonville, AR by specialty
• Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.