Active NPI
Timothy L Ackarman, PA
- Physician Assistant
- Forest City, IA
National Provider Identifier
1447368170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 001099
- Practice address
- 635 E US Hwy
Forest City, IA 50436-0000 - Phone
- (641) 585-2904
- Fax
- (641) 585-5417
- NPI assigned
- Aug 25, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 001099 | IA | Primary |
Addresses
Primary practice location
635 E US Hwy
Forest City, IA 50436-0000
Mailing address
621 S Illinois Ave
Suite 103
Mason City, IA 50401-5489
Phone (641) 494-3041
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19515 | Other | IA | WELLMARK |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001099 | IA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447368170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "621 S ILLINOIS AVE",
"address_2": "SUITE 103",
"city": "MASON CITY",
"state": "IA",
"postal_code": "504015489",
"telephone_number": "641-494-3041",
"fax_number": "641-494-3059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "635 E US HWY",
"city": "FOREST CITY",
"state": "IA",
"postal_code": "504360000",
"telephone_number": "641-585-2904",
"fax_number": "641-585-5417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACKARMAN",
"first_name": "TIMOTHY",
"middle_name": "L",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IA",
"license": "001099",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "19515",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.