Active NPI
Timothy Eilerman, RN, BSN
- Registered Nurse
- San Diego, CA
National Provider Identifier
1487013264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 38443
- Practice address
- 12400 High Bluff Dr
San Diego, CA 92130-3077 - Phone
- (800) 735-4774
- NPI assigned
- Feb 22, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 38443 | OH | Primary |
Addresses
Primary practice location
12400 High Bluff Dr
San Diego, CA 92130-3077
Mailing address
12400 High Bluff Dr
San Diego, CA 92130-3077
Phone (800) 735-4774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38443 | OH | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456099200000",
"number": "1487013264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12400 HIGH BLUFF DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921303077",
"telephone_number": "800-735-4774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12400 HIGH BLUFF DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921303077",
"telephone_number": "800-735-4774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EILERMAN",
"first_name": "TIMOTHY",
"credential": "RN, BSN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-02-22",
"last_updated": "2016-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "38443",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.