Individual provider Active NPI

Timothy Robert Wright, R.N.

  • Registered Nurse
  • Long Beach, CA
National Provider Identifier
1558789693
Registry record updated Apr 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
344419 Issued in CA
Practice address
100 W Broadway Ste 5010
Long Beach, CA 90802-9409
Phone
(562) 285-1330
Fax
(562) 263-3395
NPI assigned
Apr 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 344419 CA Primary

Addresses

Primary practice location

100 W Broadway Ste 5010
Long Beach, CA 90802-9409

Mailing address

100 W Broadway Ste 5010
Long Beach, CA 90802-9409
Phone (562) 285-1330

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
344419CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1396656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396656000000",
    "number": "1558789693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W BROADWAY STE 5010",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908029409",
            "telephone_number": "562-285-1330",
            "fax_number": "562-263-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W BROADWAY STE 5010",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908029409",
            "telephone_number": "562-285-1330",
            "fax_number": "562-263-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "TIMOTHY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-05",
        "last_updated": "2014-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "344419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2014; 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.