Individual provider Active NPI

Elouise Jane Timbang

  • Occupational Therapist
  • Hagerstown, MD
National Provider Identifier
1396120630
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
07458 Issued in MD
Practice address
14014 Marsh Pike
Hagerstown, MD 21742-1638
Phone
(301) 733-8700
NPI assigned
Jul 28, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 07458 MD Primary

Addresses

Primary practice location

14014 Marsh Pike
Hagerstown, MD 21742-1638

Mailing address

14014 Marsh Pike
Hagerstown, MD 21742-1638

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

State licenses

LicenseStateTypeSpecialty
07458MDMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1396120630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14014 MARSH PIKE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217421638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14014 MARSH PIKE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217421638",
            "telephone_number": "301-733-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMBANG",
        "first_name": "ELOUISE JANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "07458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.