Timothy Wheeler, KCSA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

SA040 Issued in KY

Practice address

1945 Scottsville Rd
B2 PMB 137
Bowling Green, KY 42104-3376

Phone

(270) 781-4828

Fax

(270) 781-4828

NPI assigned

Jan 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1386794956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 SCOTTSVILLE RD STE B2",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421045836",
            "telephone_number": "270-782-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 SCOTTSVILLE RD",
            "address_2": "B2 PMB 137",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043376",
            "telephone_number": "270-781-4828",
            "fax_number": "270-781-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "KCSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "SA040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Bennett Westfall, DO
• Lindsay Lee Wheat, APRN
• Rachel Wheat
• Janna Wheeler
• Jennifer Nicole Wheeler, LMFT
• Amanda Whelan
• Sarah Whiles, LPCA
• Billy Whitaker, RBT
• Giuliana Gulisano Whitaker
• John Whitaker, MD

• Surgical Physician Assistant in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Surgical Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.