Active NPI
Timothy F Nolan Jr., MD
- Psychiatry Physician
- Springfield, KY
National Provider Identifier
1407916760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 27153
- Practice address
- 101 Mayes Ave
Springfield, KY 40069-1415 - Phone
- (859) 336-3464
- NPI assigned
- Dec 9, 2006
- Last updated
- Feb 6, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 27153 | KY | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 27153 | KY |
Addresses
Primary practice location
101 Mayes Ave
Springfield, KY 40069-1415
Mailing address
101 Mayes Ave
Springfield, KY 40069-1415
Phone (859) 336-3464
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30605018 | Medicaid | KY | |
| 000000500349 | Other | KY | ANTHEM |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27153 | KY | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Communicare Inc | Past | Accepting new patients | |
| Communicare Inc | Past | Accepting new patients | |
| Communicare Inc | Past | Accepting new patients | |
| Communicare Inc | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Community/Behavioral Health Agency
- Springfield, KY
- NPI 1083751424
-
- Community/Behavioral Health Agency
- Bardstown, KY
- NPI 1679610117
-
- Community/Behavioral Health Agency
- Hodgenville, KY
- NPI 1821419789
-
- Community/Behavioral Health Agency
- Elizabethtown, KY
- NPI 1891832234
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423180800000",
"number": "1407916760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 MAYES AVE",
"city": "SPRINGFIELD",
"state": "KY",
"postal_code": "400691415",
"telephone_number": "859-336-3464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 MAYES AVE",
"city": "SPRINGFIELD",
"state": "KY",
"postal_code": "400691415",
"telephone_number": "859-336-3464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLAN",
"first_name": "TIMOTHY",
"middle_name": "F",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-09",
"last_updated": "2015-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "KY",
"license": "27153",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "KY",
"license": "27153",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30605018",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000500349",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.