Individual provider Active NPI

Timothy A Tharp

  • Student in an Organized Health Care Education/Training Program
  • Milton, FL
National Provider Identifier
1407769086
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
CI Issued in TX
Practice address
2744 Wallace Lake Rd
Milton, FL 32571-9172
Phone
(850) 816-9193
NPI assigned
Sep 24, 2026
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X CI TX Primary

Addresses

Primary practice location

2744 Wallace Lake Rd
Milton, FL 32571-9172

Mailing address

2186 Jackson Keller Rd Ste 2223
San Antonio, TX 78213-2723
Phone (850) 816-9193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1407769086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2186 JACKSON KELLER RD STE 2223",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782132723",
            "telephone_number": "850-816-9193",
            "fax_number": "937-962-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2744 WALLACE LAKE RD",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325719172",
            "telephone_number": "850-816-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THARP",
        "first_name": "TIMOTHY",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "CI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.