Individual provider Active NPI

Timothy C Sapp, M.D.

  • Psychiatry Physician
  • Glendale, AZ
National Provider Identifier
1407924541
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
30780 Issued in AZ
Practice address
6015 W Peoria Ave
Glendale, AZ 85302-1213
Phone
(623) 344-4400
Fax
(623) 344-4450
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 30780 AZ Primary

Addresses

Primary practice location

6015 W Peoria Ave
Glendale, AZ 85302-1213

Mailing address

6015 W Peoria Ave
Glendale, AZ 85302-1213
Phone (623) 344-4400

Other identifiers 1

IdentifierTypeStateIssuer
817596MedicaidAZ

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

LicenseStateTypeSpecialty
30780AZMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lafrontera Center Inc Past Accepting new patients
Vo of Arizona, Inc. Past Accepting new patients
Magellan Health Services of Arizona, Inc Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231977600000",
    "number": "1407924541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 W PEORIA AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853021213",
            "telephone_number": "623-344-4400",
            "fax_number": "623-344-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 W PEORIA AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853021213",
            "telephone_number": "623-344-4400",
            "fax_number": "623-344-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAPP",
        "first_name": "TIMOTHY",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2009-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "30780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "817596",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; 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.