Hayley Mignonne Timm, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

33863 Issued in NE

Practice address

20011 Manderson St
Elkhorn, NE 68022-3233

Phone

(402) 955-7840

NPI assigned

Jun 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Hayley Mignonne Faber Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: htimm43150@direct.chsomaha.org

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.

• Children'S Physicians

  • Pediatrics Physician
  • Omaha, NE
  • NPI 1750443503
  NPD (past)
• Nebraska Pediatric Practice, Inc

  • Pediatrics Physician
  • Omaha, NE
  • NPI 1144556333
  NPD (past)

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1265813232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20011 MANDERSON ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680223233",
            "telephone_number": "402-955-7840",
            "fax_number": "402-955-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20011 MANDERSON ST",
            "city": "ELKHORN",
            "state": "NE",
            "postal_code": "680223233",
            "telephone_number": "402-955-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMM",
        "first_name": "HAYLEY",
        "middle_name": "MIGNONNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-15",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301107501",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "MD-44939",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "33863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265813232",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731712",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAYLEY",
            "last_name": "FABER",
            "middle_name": "MIGNONNE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pediatrics Physician in Elkhorn, NE
• Providers in Elkhorn, NE by specialty
• Pediatrics Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.