Active NPI
Timothy Paul McDermott, PT, DPT
- Physical Therapist
- Louisville, KY
National Provider Identifier
1598360604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 007179
- Practice address
- 446 Mount Holly Ave
Louisville, KY 40206-2125 - Phone
- (502) 897-1646
- NPI assigned
- Dec 4, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 007179 | KY | Primary |
Addresses
Primary practice location
446 Mount Holly Ave
Louisville, KY 40206-2125
Mailing address
3313 Allison Way
Louisville, KY 40220-1905
Phone (502) 338-7564
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007179 | KY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607040000000",
"number": "1598360604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3313 ALLISON WAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402201905",
"telephone_number": "502-338-7564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "446 MOUNT HOLLY AVE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402062125",
"telephone_number": "502-897-1646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDERMOTT",
"first_name": "TIMOTHY",
"middle_name": "PAUL",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-04",
"last_updated": "2020-12-04",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "007179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.