Active NPI
Tim McNelis
- Case Manager/Care Coordinator
- Faribault, MN
National Provider Identifier
1609407295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 505 7TH Ave SW
Faribault, MN 55021-5914 - Phone
- (507) 210-0141
- NPI assigned
- Feb 1, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
505 7TH Ave SW
Faribault, MN 55021-5914
Mailing address
505 7TH Ave SW
Faribault, MN 55021-5914
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | FAMILY COUNSELING |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | timmcnelis@gmail.com | Health Information Exchange (HIE) | |
| CONNECT URL | timmcnelis@gmail.com | Health Information Exchange (HIE) |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1580515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580515200000",
"number": "1609407295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 7TH AVE SW",
"city": "FARIBAULT",
"state": "MN",
"postal_code": "550215914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 7TH AVE SW",
"city": "FARIBAULT",
"state": "MN",
"postal_code": "550215914",
"telephone_number": "507-210-0141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNELIS",
"first_name": "TIM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-02-01",
"last_updated": "2020-02-01",
"certification_date": "2020-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FAMILY COUNSELING",
"identifier": "NA",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "timmcnelis@gmail.com",
"affiliation": "N",
"endpointDescription": "business email address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "505 7th Ave SW",
"city": "Faribault",
"state": "MN",
"country_code": "US",
"postal_code": "550215914",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "timmcnelis@gmail.com",
"affiliation": "N",
"endpointDescription": "business email address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "505 7th Ave SW",
"city": "Faribault",
"state": "MN",
"country_code": "US",
"postal_code": "550215914",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Faribault, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.