Individual provider Active NPI

Timothy D Tobitt, DPH, FNP-C, CEO

  • Family Nurse Practitioner
  • Smithville, TN
National Provider Identifier
1396923199
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
12888 Issued in TN
Practice address
414 E Broad St
Good Health Fmaily Clinic, Inc.
Smithville, TN 37166
Phone
(615) 597-4432
Fax
(615) 597-4434
NPI assigned
Feb 4, 2008
Last updated
Jun 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 12888 TN Primary

Addresses

Primary practice location

414 E Broad St
Good Health Fmaily Clinic, Inc.
Smithville, TN 37166

Mailing address

414 E Broad St
Good Health Fmaily Clinic, Inc.
Smithville, TN 37166
Phone (615) 597-4432

Other identifiers 1

IdentifierTypeStateIssuer
33420181MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081113000357 TN Practitioner - Nurse Practitioner 5193885697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

414 E Broad St
Smithville, TN 37166-6385
Phone (615) 597-4432

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12888TNMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Good Health Family Clinic, Inc Family CurrentSince Mar 1, 2010 Accepting new patients
Summit Convenient Care at Lebanon LLC Past Accepting new patients

Locations

414 E Broad St
Smithville, TN 37166
Phone (615) 597-4432

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1396923199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 E BROAD ST",
            "address_2": "GOOD HEALTH FMAILY CLINIC, INC.",
            "city": "SMITHVILLE",
            "state": "TN",
            "postal_code": "37166",
            "telephone_number": "615-597-4432",
            "fax_number": "615-597-4434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 E BROAD ST",
            "address_2": "GOOD HEALTH FMAILY CLINIC, INC.",
            "city": "SMITHVILLE",
            "state": "TN",
            "postal_code": "37166",
            "telephone_number": "615-597-4432",
            "fax_number": "615-597-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBITT",
        "first_name": "TIMOTHY",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "DPH, FNP-C, CEO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-04",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "12888",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33420181",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithville, TN

Sources for this page

Verify at the official NPI Registry.