Individual provider Active NPI

Debra Louise Timperley, O.D.

  • Optometrist
  • Saint Cloud, MN
National Provider Identifier
1487785309
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2550 Issued in MN
Practice address
380 33Rd Ave S
Walmart Vision Center 1633
Saint Cloud, MN 56301-3716
Phone
(320) 259-5880
Fax
(320) 259-6084
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2550 MN Primary

Addresses

Primary practice location

380 33Rd Ave S
Walmart Vision Center 1633
Saint Cloud, MN 56301-3716

Mailing address

2220 13TH St S
Saint Cloud, MN 56301-4861
Phone (320) 492-7916

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2550MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas N Johnson Optometric Corp Optometrist Past Accepting new patients
Walmart Inc. Past Accepting new patients

Organizations & group practices 2

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1487785309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 13TH ST S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014861",
            "telephone_number": "320-492-7916",
            "fax_number": "320-202-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 33RD AVE S",
            "address_2": "WALMART VISION CENTER 1633",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013716",
            "telephone_number": "320-259-5880",
            "fax_number": "320-259-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMPERLEY",
        "first_name": "DEBRA",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.