Timothy Andrew Marvin, LSA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

SA00018 Issued in TX

Practice address

171 Rock House Dr
Liberty Hill, TX 78642-6305

Phone

(512) 656-2928

Fax

(512) 656-2928

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Liberty Hill Surgery Center LLC

  • Surgical Assistant
  • Liberty Hill, TX
  • NPI 1669845632
  NPD (past) Authorized official
• T.M. First Assisting Inc.

  • Surgical Assistant
  • Liberty Hill, TX
  • NPI 1407031156
  NPD (past) Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1497866263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 ROCK HOUSE DR",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786426305",
            "telephone_number": "512-656-2928",
            "fax_number": "512-656-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ROCK HOUSE DR",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786426305",
            "telephone_number": "512-656-2928",
            "fax_number": "512-656-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARVIN",
        "first_name": "TIMOTHY",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "LSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "SA00018",
            "primary": true
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "CO",
            "license": "F01177",
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "CO",
            "license": "F01177",
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "TX",
            "license": "SA00018",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERIFIED FIRST ASSISTANT",
            "identifier": "F01177",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE SURGICAL ASSISTANT",
            "identifier": "SA00018",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liberty Hill Surgery Center LLC
• Liberty Hill Vision PLLC
• James Alfred Lyons III, MD
• M & L Pharmacy
• M B Systems LTD
• Kristen McAdams, LPC
• Ashlee N McBride, M.ED, BCBA
• Christopher McClung
• Vanessa Rae McIntosh
• Meridell Achievement Center

• Surgical Assistant in Liberty Hill, TX
• Providers in Liberty Hill, TX by specialty
• Surgical Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.