Timothy M West, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

TC6664 Issued in KY

Practice address

875 Pennsylvania Ave
Bardstown, KY 40004-2529

Phone

(502) 348-5685

Fax

(502) 348-1771

NPI assigned

May 25, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1265643878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LIBERTY ST STE 800",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021428",
            "telephone_number": "502-540-3383",
            "fax_number": "502-540-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 PENNSYLVANIA AVE",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400042529",
            "telephone_number": "502-348-5685",
            "fax_number": "502-348-1771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "289 Ireland Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Knox",
            "state": "KY",
            "postal_code": "401215111",
            "country_code": "US",
            "telephone_number": "502-624-0640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEST",
        "first_name": "TIMOTHY",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC6664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA CERTIFICATION #",
            "identifier": "1044689",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Wagoner Walton, OT/L
• Kristi Watson, M.S LCADC, CCTP, BIP
• L'Cris Amaru Real Weathers, DMD
• Ciara Weir, CADC
• Andrew Wickham Werner, DMD
• Kimberly Wheatley, RPH
• Charity Wickliffe
• Brian Alexander Williams, MD
• Ginger Nichole Williams, APRN
• Kassie Williams, CSW

• Physician Assistant in Bardstown, KY
• Providers in Bardstown, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; 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.