Individual provider Active NPI

Timothy R Horn, M.D.

  • Internal Medicine Physician
  • Lake Worth, FL
National Provider Identifier
1376624338
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0051229 Issued in FL
Practice address
4140 Lake Worth Rd
Lake Worth, FL 33461-3901
Phone
(561) 965-9638
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0051229 FL Primary

Addresses

Primary practice location

4140 Lake Worth Rd
Lake Worth, FL 33461-3901

Mailing address

4140 Lake Worth Rd
Lake Worth, FL 33461-3901
Phone (561) 965-9638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20181114003322 OR Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3678770054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0051229FLMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: thorn@ccmgclinics.gwaydirect.com

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1376624338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 LAKE WORTH RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334613901",
            "telephone_number": "561-965-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 LAKE WORTH RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334613901",
            "telephone_number": "561-965-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORN",
        "first_name": "TIMOTHY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "0051229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.