Marisa Courtney Timmins, SPEECH THERAPIST

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP00375-P Issued in RI

Practice address

1000 Eddy St
Providence, RI 02905-4739

Phone

(401) 533-9100

Fax

(401) 533-9105

NPI assigned

Sep 7, 2017

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497273718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054739",
            "telephone_number": "401-533-9100",
            "fax_number": "401-533-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054739",
            "telephone_number": "401-533-9100",
            "fax_number": "401-533-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMMINS",
        "first_name": "MARISA",
        "middle_name": "COURTNEY",
        "credential": "SPEECH THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "RI",
            "license": "SP00375-P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ES01788",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH OF RI",
            "identifier": "0614",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "SB870",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adriana Tifa
• Susan Beth Tiller, RD
• Anastasia Caroline Tillman
• Paul Tillyer, DPT
• Times 2 Stem Academy
• Holly Christine Tindall, APRN-CNP
• Fenella Ting
• Alfredo Tirado, MD
• Chanakya Charan Tirumala, MD
• Charles Tita Tita, MD

• Speech-Language Pathologist in Providence, RI
• Providers in Providence, RI by specialty
• Speech-Language Pathologist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.