Individual provider Active NPI

Timmy Sumra, MD

  • Family Medicine Physician
  • Minot, ND
National Provider Identifier
1306675152
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RL21135 Issued in ND
Practice address
1201 11TH Ave SW
Minot, ND 58701-4207
Phone
(701) 858-6700
NPI assigned
Jul 30, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RL21135 ND Primary

Addresses

Primary practice location

1201 11TH Ave SW
Minot, ND 58701-4207

Mailing address

1201 11TH Ave SW
Minot, ND 58701-4207
Phone (701) 858-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20240816002191 ND Order and Referring Only - Family PracticePractitioner - Family Practice 5496293821

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1306675152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 11TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014207",
            "telephone_number": "701-858-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 11TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587014207",
            "telephone_number": "701-858-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMRA",
        "first_name": "TIMMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "RL21135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

Verify at the official NPI Registry.