Individual provider Active NPI

Timothy Roy Ankenman, RD

  • Registered Dietitian
  • Meridian, ID
National Provider Identifier
1235069964
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
D-1301 Issued in ID
Practice address
5155 S Hillsdale Ave
Meridian, ID 83642-7587
Phone
(208) 706-9710
Fax
(208) 706-9728
NPI assigned
May 22, 2026
Last updated
Jun 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D-1301 ID Primary
Registered Dietitian 133V00000X 86066149
Sports Dietetics Nutrition Registered Dietitian 133VN1501X 86066149

Addresses

Primary practice location

5155 S Hillsdale Ave
Meridian, ID 83642-7587

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other names 1

  • Mr. Tim Roy Ankenman Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
University of Mississippi School of Medicine, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Boise, ID 83701

PO Box
Suite 640
Boise, ID 83701-0640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D-1301IDMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1779408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1235069964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5155 S HILLSDALE AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427587",
            "telephone_number": "208-706-9710",
            "fax_number": "208-706-9728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANKENMAN",
        "first_name": "TIMOTHY",
        "middle_name": "ROY",
        "name_prefix": "Mr.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-22",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": "D-1301",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": "86066149",
            "primary": false
        },
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": null,
            "license": "86066149",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIM",
            "last_name": "ANKENMAN",
            "middle_name": "ROY",
            "prefix": "MR.",
            "credential": "RD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.