Individual provider Active NPI

John A. Timmons, M.D.

  • Emergency Medicine Physician
  • Watseka, IL
National Provider Identifier
1245224641
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-070729 Issued in IL
Practice address
200 E Fairman Ave
Watseka, IL 60970-1644
Phone
(630) 321-8300
Fax
(630) 321-8750
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-070729 IL Primary

Addresses

Primary practice location

200 E Fairman Ave
Watseka, IL 60970-1644

Mailing address

810 Quail Ridge Dr
Westmont, IL 60559-6142
Phone (630) 321-8300

Other practice location 1

530 Park Ave E
Princeton, IL 61356
Phone (815) 875-2811

Other identifiers 1

IdentifierTypeStateIssuer
036-070729MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address john.timmons@perry.cernerdirect.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040317001263 IL Practitioner - Emergency Medicine 7012819519 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rush Medical College of Rush University, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hoopeston Emergency Medicine Specialists LTDGroup PAC ID 0941102446, 12 clinicians

Practice addresses (Care Compare)

701 E Orange St
Hoopeston, IL 60942-1801
Phone (708) 393-7537

Hospital & facility affiliations

  • Carle Hoopeston Regional Health Center Hospital, Hoopeston, IL, CCN 141316

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-070729ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iroquois Memorial Hospital and Resident Home Current Accepting new patients
Hoopeston Community Memorial Hospital Emergency Medicine CurrentSince Oct 1, 2003 Accepting new patients
Hoopeston Emergency Medicine Specialists, LTD. Emergency Medicine CurrentSince Jun 30, 2003 Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Apr 30, 2003 Accepting new patients
Greater Elgin Emergency Specialists LTD Emergency Medicine Past Accepting new patients

Locations

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

200 E Fairman Ave
Watseka, IL 60970
Phone (815) 432-5201

Interoperability endpoints

  • Direct secure messaging: john.timmons@perry.cernerdirect.com
  • Direct secure messaging: jtimmonsmd154789@carlehiedirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1245224641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 QUAIL RIDGE DR",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605596142",
            "telephone_number": "630-321-8300",
            "fax_number": "630-321-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E FAIRMAN AVE",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701644",
            "telephone_number": "630-321-8300",
            "fax_number": "630-321-8750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 Park Ave E",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "IL",
            "postal_code": "61356",
            "country_code": "US",
            "telephone_number": "815-875-2811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMMONS",
        "first_name": "JOHN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-070729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-070729",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "john.timmons@perry.cernerdirect.com",
            "affiliation": "N",
            "address_1": "530 Park Ave E",
            "city": "Princeton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "61356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Watseka, IL

Sources for this page

Verify at the official NPI Registry.