Individual provider Active NPI

Timothy Ellis Messmer, D.P.M.

  • Podiatrist
  • Mount Vernon, WA
National Provider Identifier
1477552701
Registry record updated Dec 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO00000477 Issued in WA
Practice address
1401 S Laventure Rd
Mount Vernon, WA 98274-6033
Phone
(360) 424-2400
Fax
(360) 424-2418
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO00000477 WA Primary

Addresses

Primary practice location

1401 S Laventure Rd
Mount Vernon, WA 98274-6033

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Other identifiers 2

IdentifierTypeStateIssuer
43083OtherWALABOR AND INDUSTRIES
1083476MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO00000477WAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S CurrentSince Jan 1, 2014 Accepting new patients
Proliance Surgeons, Inc., P.S. Podiatrist CurrentSince Jan 1, 2014 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Family Foot and Ankle Care Incorporation Podiatrist Past Accepting new patients

Locations

1017 20th St
Anacortes, WA 98221
Phone (360) 424-7041

1500 Continental Pl
Mount Vernon, WA 98273
Phone (360) 424-7041

1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: timothy.messmer.p15@direct.proliance.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388361600000",
    "number": "1477552701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S LAVENTURE RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982746033",
            "telephone_number": "360-424-2400",
            "fax_number": "360-424-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSMER",
        "first_name": "TIMOTHY",
        "middle_name": "ELLIS",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2013-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO00000477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "43083",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083476",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.