Timothy M Brown, OD, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008505 Issued in IL

Legal business name

TIMOTHY M BROWN, OD, PC

Practice address

715 Walnut St
Mount Carmel, IL 62863-1465

Phone

(618) 263-3165

NPI assigned

Aug 5, 2007

Last updated

Feb 13, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Michael Brown, ODNPI 1093884900

Title

President

Phone

(618) 263-3165

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy M Brown, OD

  • Optometrist
  • Mount Carmel, IL
  • NPI 1093884900
  Medicare reassignment NPD Authorized official
• Kara Lynn Tison, OD

  • Pediatric Optometrist
  • Louisville, KY
  • NPI 1174878375
  NPD (past)
• Christine M Verbeck, O. D.

  • Optometrist
  • Evansville, IN
  • NPI 1992777031
  NPD (past)

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392249600000",
    "number": "1376734483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 WALNUT ST",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628631465",
            "telephone_number": "618-263-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 WALNUT ST",
            "city": "MOUNT CARMEL",
            "state": "IL",
            "postal_code": "628631465",
            "telephone_number": "618-263-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY M BROWN, OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2014-02-13",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-263-3165",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008505",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SUPPLIER",
            "identifier": "046008505",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "209199",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teri N Stangle, M.A.
• Ellie Raven Steinhart
• Allison Stephens
• Rachel A Stephens, ATC, LAT
• Sydney Jade Straw, MSW
• Tri State Precision Clinic of Chiropractic Inc (Tri-state Clinic of Chiropractic)
• Tri-State Clinic of Chiropractic, PC
• Vna Homecare, Inc. (TIP Hospice)
• Vna Homecare, Inc. (VNA-TIP HomeCare)
• Wabash Area Vocational Enterprises, Inc.

• Optometrist in Mount Carmel, IL
• Providers in Mount Carmel, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.