NPIMap

Individual provider Active NPI

Timothy P Culligan, MD

  • Family Medicine Physician
  • Kaukauna, WI
National Provider Identifier
1447216767
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0042632 Issued in WI
Practice address
305 E 12TH St
Kaukauna, WI 54130-2865
Phone
(920) 766-4656
Fax
(920) 766-4659
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0042632 WI Primary

Addresses

Primary practice location

305 E 12TH St
Kaukauna, WI 54130-2865

Mailing address

305 E 12TH St
Kaukauna, WI 54130-2865
Phone (920) 766-4656

Other identifiers 1

IdentifierTypeStateIssuer
34030300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050413001184 WI Practitioner - Family Practice 8921045683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loyola University of Chicago, Stritch School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaukauna Clinic, S.C.Group PAC ID 5597765891, 8 clinicians

Practice addresses (Care Compare)

305 E 12TH St
Kaukauna, WI 54130-2865
Phone (920) 766-4656

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0042632WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaukauna Clinic, S.C. Family Medicine CurrentSince Aug 12, 2002 Accepting new patients

Locations

305 E 12th St
Kaukauna, WI 54130
Phone (920) 731-3111

Interoperability endpoints

  • Direct secure messaging: tculligan27055@direct.thedacare.org

Organizations & group practices 1

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.

Hospital & facility affiliations 12

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1447216767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E 12TH ST",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541302865",
            "telephone_number": "920-766-4656",
            "fax_number": "920-766-4659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E 12TH ST",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541302865",
            "telephone_number": "920-766-4656",
            "fax_number": "920-766-4659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULLIGAN",
        "first_name": "TIMOTHY",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "0042632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34030300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaukauna, WI

Sources for this page

Verify at the official NPI Registry.