Individual provider Active NPI

Timothy J. McKindles, CRNA

  • Certified Registered Nurse Anesthetist
  • Groveland, FL
National Provider Identifier
1376656504
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
041226218 Issued in IL
Practice address
328 Salt Marsh LN
Groveland, FL 34736-3639
Phone
(352) 404-6094
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 041226218 IL Primary

Addresses

Primary practice location

328 Salt Marsh LN
Groveland, FL 34736-3639

Mailing address

328 Salt Marsh LN
Groveland, FL 34736-3639
Phone (352) 404-6094

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
041226218ILMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1376656504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 SALT MARSH LN",
            "city": "GROVELAND",
            "state": "FL",
            "postal_code": "347363639",
            "telephone_number": "352-404-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 SALT MARSH LN",
            "city": "GROVELAND",
            "state": "FL",
            "postal_code": "347363639",
            "telephone_number": "352-404-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINDLES",
        "first_name": "TIMOTHY",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041226218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groveland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; 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.