Active NPI
Timothy S Brooks DPM
- Podiatrist
- Titusville, PA
National Provider Identifier
1609052208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- Legal business name
- TIMOTHY S BROOKS DPM
- Practice address
- 122 N Franklin St
Titusville, PA 16354-1761 - Phone
- (814) 827-2841
- Fax
- (814) 827-0746
- NPI assigned
- Jan 14, 2008
- Last updated
- Nov 8, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Timothy S Brooks, DPM
- Title
- Owner
- Phone
- (814) 827-2841
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | NU | Primary |
Addresses
Primary practice location
122 N Franklin St
Titusville, PA 16354-1761
Mailing address
122 N Franklin St
Titusville, PA 16354-1761
Phone (814) 827-2841
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930072229 | PA | DME Supplier - Physician - Podiatry | 5496875346 | Practice locations: Titusville, PA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Podiatrist
- Titusville, PA
- NPI 1407826621
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200268800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1320710400000",
"number": "1609052208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 N FRANKLIN ST",
"city": "TITUSVILLE",
"state": "PA",
"postal_code": "163541761",
"telephone_number": "814-827-2841",
"fax_number": "814-827-0746"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 N FRANKLIN ST",
"city": "TITUSVILLE",
"state": "PA",
"postal_code": "163541761",
"telephone_number": "814-827-2841",
"fax_number": "814-827-0746"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TIMOTHY S BROOKS DPM",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-14",
"last_updated": "2011-11-08",
"status": "A",
"authorized_official_last_name": "BROOKS",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "814-827-2841",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Titusville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.