Individual provider Active NPI

Timothy Allotey Pappoe, MD

  • Neonatal-Perinatal Medicine Physician
  • Carbondale, IL
National Provider Identifier
1336155878
Registry record updated Dec 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
036108026 Issued in IL
Practice address
405 W Jackson St
Carbondale, IL 62901-1462
Phone
(618) 549-0721
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 036108026 IL Primary

Addresses

Primary practice location

405 W Jackson St
Carbondale, IL 62901-1462

Mailing address

PO Box 1105
Indianapolis, IN 46206-1105
Phone (618) 457-5200

Other identifiers 1

IdentifierTypeStateIssuer
214881OtherILMEDICARE GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180110000607 TX Practitioner - Pediatric Medicine 6507168531 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group CurrentSince Nov 2, 2022 Accepting new patients
Pediatrix Medical Group of Texas Billing, Inc. Neonatal-Perinatal Medicine CurrentSince Sep 30, 2017 Accepting new patients
Magella Medical Associates Billing, Inc. Neonatal-Perinatal Medicine CurrentSince Sep 30, 2017 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
St Joseph Regional Health Center Past Accepting new patients

Locations

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

1102 Bates Ave
#1450
Houston, TX 77030

101 W Expressway 83
McAllen, TX 78503
Phone (956) 661-9840

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

8811 Village Dr
San Antonio, TX 78217
Phone (210) 297-2000

5430 Fredericksburg Rd
Ste 508
San Antonio, TX 78229
Phone (210) 541-8281

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451520000000",
    "number": "1336155878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1105",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061105",
            "telephone_number": "618-457-5200",
            "fax_number": "618-351-4820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W JACKSON ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011462",
            "telephone_number": "618-549-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPOE",
        "first_name": "TIMOTHY",
        "middle_name": "ALLOTEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2015-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IL",
            "license": "036108026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "214881",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.