Individual provider Active NPI

Timothy J Kilkenny, MD

  • Pediatrics Physician
  • Canton, OH
National Provider Identifier
1467411934
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35071572 Issued in OH
Practice address
2600 Sixth St SW
Canton, OH 44710-1702
Phone
(330) 438-7430
Fax
(330) 580-5542
NPI assigned
Mar 22, 2006
Last updated
Mar 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35071572 OH Primary

Addresses

Primary practice location

2600 Sixth St SW
Canton, OH 44710-1702

Mailing address

1 Perkins SQ
Akron, OH 44308-1063
Phone (330) 438-7430

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tkilkenny27350@direct.chmca.org
Direct Messaging Address tkilkenny27350@direct.chmca.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140307001394 OH Practitioner - Pediatric Medicine 0446480693 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35071572OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Medical Center of Akron Current Accepting new patients
Children's Hospital Medical Center of Akron CurrentSince Jan 28, 2014 Accepting new patients
Children's Hospital Medical Center of Akron Pediatrics CurrentSince Jan 28, 2014 Accepting new patients
Akron Children's Hospital Current Accepting new patients
Children's Hospital Medical Center of Akron Past Accepting new patients

Locations

1 Perkins Sq
Akron, OH 44308
Phone (330) 543-8050

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

Interoperability endpoints

  • Direct secure messaging: tkilkenny883160@direct.bsmhealth.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1467411934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-438-7430",
            "fax_number": "330-580-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SIXTH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-438-7430",
            "fax_number": "330-580-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILKENNY",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35071572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkilkenny27350@direct.chmca.org",
            "affiliation": "N",
            "address_1": "2600 Sixth St SW",
            "city": "Canton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "447101702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkilkenny27350@direct.chmca.org",
            "affiliation": "N",
            "address_1": "2600 Sixth St SW",
            "city": "Canton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "447101702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.