Individual provider Active NPI

Timothy Michael Chestnut, M.D.

  • Internal Medicine Physician
  • Spokane, WA
National Provider Identifier
1376531632
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD 00020134 Issued in WA
Practice address
7209 S. South Meadows Rd
Spokane, WA 99223
Phone
(509) 994-5442
Fax
(509) 448-8917
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD00020134 WA
Pulmonary Disease Physician 207RP1001X MD00020134 WA
Internal Medicine Physician 207R00000X MD 00020134 WA Primary

Addresses

Primary practice location

7209 S. South Meadows Rd
Spokane, WA 99223

Mailing address

7209 S. South Meadows Rd
Spokane, WA 99223
Phone (509) 994-5442

Other identifiers 1

IdentifierTypeStateIssuer
1066984MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20140821000000 WA Practitioner - Internal MedicinePractitioner - Pulmonary DiseasePractitioner - Other (Physician) 6507003274 Practice locations: Clarkston, WA; Spokane, WA; Spokane Valley, WA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 00020134WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hanger Prosthetics & Orthotics Inc Past Accepting new patients

Organizations & group practices 1

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1376531632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7209 S. SOUTH MEADOWS RD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99223",
            "telephone_number": "509-994-5442",
            "fax_number": "509-448-8917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7209 S. SOUTH MEADOWS RD",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99223",
            "telephone_number": "509-994-5442",
            "fax_number": "509-448-8917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESTNUT",
        "first_name": "TIMOTHY",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WA",
            "license": "MD00020134",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD00020134",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD 00020134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1066984",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.