Timothy Michael Flaherty, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2486 Issued in MN

Practice address

1881 E Madison Ave
Mankato, MN 56001-6200

Phone

(507) 388-9805

Fax

(507) 388-9812

NPI assigned

Nov 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1477632057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 STONEHENGE DR",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560019334",
            "telephone_number": "507-345-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 E MADISON AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016200",
            "telephone_number": "507-388-9805",
            "fax_number": "507-388-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAHERTY",
        "first_name": "TIMOTHY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAYO",
            "identifier": "1880048",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "22-00932",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "19979",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Fitzsimmons
• Five Rivers Mental Health LLC (Five Rivers Mental Health Clinic LLC)
• Five Star DME and Billing
• Grace A Fjeldberg, LD, RD
• Maura Ann Flaherty, MS, LAMFT
• Kamille J Flandrena
• Patrick Michael Flanigan, MD
• Kaylee Flatoff, REGISTERED DIETITIAN
• Richard H Fleming, MD
• Myranda Sue Fletcher

• Optometrist in Mankato, MN
• Providers in Mankato, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.