Timothy Payne, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10000956 Issued in WA

Practice address

1000 Wallace Way
Grandview, WA 98930-8805

Phone

(509) 882-3444

Fax

(509) 882-2049

NPI assigned

Oct 5, 2006

Last updated

Jul 8, 2007By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Yakima Valley Farm Workers Clinic

  dba Casa De Esperanza Grandview

  • Federally Qualified Health Center (FQHC)
  • Grandview, WA
  • NPI 1003945205
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558457754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989480190",
            "telephone_number": "509-865-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WALLACE WAY",
            "city": "GRANDVIEW",
            "state": "WA",
            "postal_code": "989308805",
            "telephone_number": "509-882-3444",
            "fax_number": "509-882-2049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "TIMOTHY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10000956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flint Orr
• Tiffany Owens
• Peter S Park, FNP
• Pitchaya Pattasema
• Aysha Paxman, PA-C
• Joseph Isiah Penaflor, DNP, PMHNP-BC
• Leon Socorro Perez, L.M.P.
• Emily Suzanne Perry, SLP
• Joel Christian Pina
• Gerald R Poff, M.P.T

• Medical Physician Assistant in Grandview, WA
• Providers in Grandview, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.