NPIMap

Individual provider Active NPI

Timothy James Collins, M.D.

  • Family Medicine Physician
  • Etowah, TN
National Provider Identifier
1235126392
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30261 Issued in TN
Practice address
305 Grady Rd
Suite B
Etowah, TN 37331-1903
Phone
(423) 263-0722
Fax
(423) 263-5232
NPI assigned
Oct 4, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30261 TN Primary

Addresses

Primary practice location

305 Grady Rd
Suite B
Etowah, TN 37331-1903

Mailing address

305 Grady Rd
Suite B
Etowah, TN 37331-1903
Phone (423) 263-0722

Other identifiers 1

IdentifierTypeStateIssuer
3824140MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100831000382 TN Practitioner - Family Practice 3072675925 Reassigns benefits to 1 organization
Practice locations: Etowah, TN

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athens Physicians Practice LLCGroup PAC ID 2163490319, 33 clinicians

Practice addresses (Care Compare)

305 Grady Rd
Suite B
Etowah, TN 37331-1911
Phone (423) 263-0722

719 Cook Dr
Athens, TN 37303-3495

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30261TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Physicians Practice LLC CurrentSince Aug 1, 2017 Accepting new patients
Athens Physicians Practice LLC Family Medicine CurrentSince Aug 1, 2017 Accepting new patients
Athens Physicians Practice, LLC Family Medicine Current Accepting new patients
Athens Physicians Practice LLC Family Medicine Past Accepting new patients
Woods Memorial Hospital Past Accepting new patients

Locations

711 Cook Dr
Ste 100
Athens, TN 37303
Phone (423) 744-7585

719 Cook Dr
Ste 104
Athens, TN 37303
Phone (423) 745-9770

305 Grady Rd
Ste B
Etowah, TN 37331
Phone (423) 263-0722

872 Highway 411 N
Unit G
Etowah, TN 37331
Phone (423) 744-7585

886 Highway 411 N
Etowah, TN 37331
Phone (423) 263-3600

Interoperability endpoints

  • Direct secure messaging: dr_timothy_collins@yourcarecommunity.org
  • Direct secure messaging: timothy.collins.1@19363.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235126392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 GRADY RD",
            "address_2": "SUITE B",
            "city": "ETOWAH",
            "state": "TN",
            "postal_code": "373311903",
            "telephone_number": "423-263-0722",
            "fax_number": "423-263-5232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 GRADY RD",
            "address_2": "SUITE B",
            "city": "ETOWAH",
            "state": "TN",
            "postal_code": "373311903",
            "telephone_number": "423-263-0722",
            "fax_number": "423-263-5232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "30261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3824140",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Etowah, TN

Sources for this page

Verify at the official NPI Registry.