Active NPI
Levi Roland Timko, PTA
- Physical Therapy Assistant
- Omaha, NE
National Provider Identifier
1396094595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 004959
- Practice address
- 11623 Arbor Street
Omaha, NE 68144 - Phone
- (402) 590-5831
- NPI assigned
- Sep 4, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 004959 | IA | Primary |
Addresses
Primary practice location
11623 Arbor Street
Omaha, NE 68144
Mailing address
1161 W Summit St
Winterset, IA 50273
Phone (308) 293-5247
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004959 | IA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346716800000",
"number": "1396094595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1161 W SUMMIT ST",
"city": "WINTERSET",
"state": "IA",
"postal_code": "50273",
"telephone_number": "308-293-5247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11623 ARBOR STREET",
"city": "OMAHA",
"state": "NE",
"postal_code": "68144",
"telephone_number": "402-590-5831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIMKO",
"first_name": "LEVI",
"middle_name": "ROLAND",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-04",
"last_updated": "2012-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IA",
"license": "004959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.