Timothy J Smith, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C33847 Issued in CA

Practice address

5281 Thomas Rd
Sebastopol, CA 95472-9374

Phone

(707) 823-6161

Fax

(707) 824-0111

NPI assigned

Apr 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 30, 2015 through Nov 30, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477676336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5281 THOMAS RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954729374",
            "telephone_number": "707-823-6161",
            "fax_number": "707-824-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5281 THOMAS RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954729374",
            "telephone_number": "707-823-6161",
            "fax_number": "707-824-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C33847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siskiyou Rural Housecalls Medical Corporation
• Kaitlin Sisson, CMT, NMT
• Julie Clare Smith, P.T.
• Phoebe L Smith, M.D.
• Teresa Smith
• Max Cleatis Snell
• Lara Kirsten Sodergren, LM
• Solace Group LLC (Solace Therapy Group)
• Anya Rose Soled, OTR/L
• Donald Alan Solomon, M.D.

• Family Medicine Physician in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Family Medicine Physician in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.