Timothy Stanley O'Brien, PEDORTHIST

Primary specialty

SpecialistTaxonomy code 174400000X

License

PED73 Issued in FL

Practice address

2641 SE Ocean Blvd
Stuart, FL 34996-3401

Phone

(772) 283-3833

Fax

(772) 283-5632

NPI assigned

Jun 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Park Shoes Inc.

  • Durable Medical Equipment & Medical Supplies
  • Stuart, FL
  • NPI 1477720894
  NPD (past)
• Park Shoes, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Tequesta, FL
  • NPI 1518157387
  NPD (past)

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210550400000",
    "number": "1295938322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 S US HIGHWAY 1",
            "city": "TEQUESTA",
            "state": "FL",
            "postal_code": "334692701",
            "telephone_number": "561-746-3536",
            "fax_number": "561-144-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2641 SE OCEAN BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349963401",
            "telephone_number": "772-283-3833",
            "fax_number": "772-283-5632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "TIMOTHY",
        "middle_name": "STANLEY",
        "name_prefix": "Mr.",
        "credential": "PEDORTHIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2008-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "PED73",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nxpath Psychiatry LLC
• Nxpath Urology LLC
• Dominic Nyanfor
• Tracie S Nyanfor
• Caitlin O'Brien
• Allyson O'Connor
• Amanda Renee O'Connor, APRN
• Dennis A O'Connor, OTR-L
• Martine Claude O'Connor, M.S. CCC-SLP
• Paul Edward O'Malley, RPH

• Specialist in Stuart, FL
• Providers in Stuart, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.