Jeremy Patrick Timm, M.D.

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

University of Utah School of Medicine
30 North 1900 East, RM 4C104
Salt Lake City, UT 84132-0001

Phone

(801) 585-5559

NPI assigned

Apr 19, 2011

Last updated

Apr 19, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1477843878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10215 REAVIS GARDENS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631237339",
            "telephone_number": "801-870-7868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF UTAH SCHOOL OF MEDICINE",
            "address_2": "30 NORTH 1900 EAST, RM 4C104",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320001",
            "telephone_number": "801-585-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMM",
        "first_name": "JEREMY",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-19",
        "last_updated": "2011-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Tillotson
• Shannon L Tilly, MD
• Lloyd V Tilt, DDS,MS
• Joel Dela Cruz Timbol
• Arthur Iulius Timbus, M.D.
• Kathleen Halley Timme, MD
• Anna Timothy
• Christian James Timothy
• Lynn Timothy, RN
• David G Timpson, MD

• Student in an Organized Health Care Education/Training Program in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Student in an Organized Health Care Education/Training Program in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.