Individual provider Active NPI

Timothy Wierson, M.D.

  • Surgery Physician
  • Bowling Green, KY
National Provider Identifier
1295731602
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
26264 Issued in KY
Practice address
484 Golden Autumn Way Ste 201
Bowling Green, KY 42103
Phone
(270) 783-3340
Fax
(270) 780-0492
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 26264 KY Primary

Addresses

Primary practice location

484 Golden Autumn Way Ste 201
Bowling Green, KY 42103

Mailing address

201 Park St
Bowling Green, KY 42101-1759
Phone (270) 781-5111

Other practice location 1

350 Park St
Bowling Green, KY 42101-1784
Phone (270) 781-5111

Other identifiers 1

IdentifierTypeStateIssuer
64262645MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20100426000076 KY Practitioner - General Surgery 0749317634 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Iowa, RJ & L Carver College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bowling Green-Warren County Community Hospital CorporationGroup PAC ID 7719899947, 117 clinicians

Practice addresses (Care Compare)

350 Park St
Bowling Green, KY 42101-1784

825 2ND Ave
Suite C1
Bowling Green, KY 42101-1791
Phone (270) 780-2690

Hospital & facility affiliations

  • The Medical Center (Bowling Green) Hospital, Bowling Green, KY, CCN 180013

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)30
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux15
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26264KYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bowling Green-Warren County Community Hospital Corporation Surgery CurrentSince Feb 6, 2024 Accepting new patients
Graves Gilbert Clinic PLLC CurrentSince Dec 7, 1996 Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Oct 2, 2023 Accepting new patients
Commonwealth Health Corporation, Inc Current Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Oct 2, 2023 Accepting new patients
Bowling Green-Warren County Community Hospital Corporation Current Accepting new patients
Bowling Green-Warren County Community Hospital Corporation CurrentSince Feb 6, 2024 Accepting new patients
Graves Gilbert Clinic PLLC CurrentSince Dec 7, 1996 Accepting new patients
Bowling Green-Warren County Community Hospital Corporation Past Accepting new patients

Locations

2625 Scottsville Rd
Bowling Green, KY 42104
Phone (270) 745-0942

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

825 2nd Ave
Ste C1
Bowling Green, KY 42101
Phone (270) 780-2690

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

350 Park St
Ste 206
Bowling Green, KY 42101
Phone (270) 746-0440

350 Park St
Bowling Green, KY 42101
Phone (270) 783-3364

484 Golden Autumn Way
Ste 201
Bowling Green, KY 42103
Phone (270) 783-3300

Organizations & group practices 9

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 1

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1295731602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011759",
            "telephone_number": "270-781-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 GOLDEN AUTUMN WAY STE 201",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42103",
            "telephone_number": "270-783-3340",
            "fax_number": "270-780-0492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Park St",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421011784",
            "country_code": "US",
            "telephone_number": "270-781-5111",
            "fax_number": "270-780-0478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIERSON",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "26264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64262645",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.