Individual provider Active NPI

David Francis Timmer, M.S.W.

  • Clinical Social Worker
  • Hales Corners, WI
National Provider Identifier
1639286552
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1722 123 Issued in WI
Practice address
5300 S 108TH St
12B
Hales Corners, WI 53130-1368
Phone
(414) 529-2591
Fax
(414) 529-2669
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1722 123 WI Primary
Marriage & Family Therapist 106H00000X 284 124 WI

Addresses

Primary practice location

5300 S 108TH St
12B
Hales Corners, WI 53130-1368

Mailing address

5300 S 108TH St
12B
Hales Corners, WI 53130-1368
Phone (414) 529-2591

Other identifiers 1

IdentifierTypeStateIssuer
39653900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070911000691 WI Practitioner - Clinical Social Worker 9436242195 Reassigns benefits to 1 organization
Practice locations: Hales Corners, WI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trillium Care Group LLCGroup PAC ID 7618935529, 4 clinicians

Practice addresses (Care Compare)

2363 S 102ND St
Suite 301
West Allis, WI 53227-2143
Phone (262) 782-2090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1722 123WIMDClinical Social Worker
284 124WIMDMarriage & Family Therapist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1639286552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 S 108TH ST",
            "address_2": "12B",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301368",
            "telephone_number": "414-529-2591",
            "fax_number": "414-529-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 S 108TH ST",
            "address_2": "12B",
            "city": "HALES CORNERS",
            "state": "WI",
            "postal_code": "531301368",
            "telephone_number": "414-529-2591",
            "fax_number": "414-529-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMMER",
        "first_name": "DAVID",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1722 123",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "284 124",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39653900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hales Corners, WI

Sources for this page

Verify at the official NPI Registry.