Individual provider Active NPI

Timothy Gabbert, D.O.

  • Family Medicine Physician
  • Clinton, MO
National Provider Identifier
1649247727
Registry record updated Apr 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R3D43 Issued in MO
Practice address
1602 N 2ND St
Clinton, MO 64735-1192
Phone
(660) 885-8171
Fax
(660) 890-8495
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R3D43 MO Primary

Addresses

Primary practice location

1602 N 2ND St
Clinton, MO 64735-1192

Mailing address

1602 N 2ND St
Clinton, MO 64735-1192
Phone (660) 885-8171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040504000568 MO Practitioner - Family PracticePractitioner - Emergency Medicine 8426046939 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R3D43MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Valley Memorial Hospital District CurrentSince Apr 1, 2004 Accepting new patients
Golden Valley Memorial Hospital District Current Accepting new patients
Golden Valley Memorial Hospital District CurrentSince Apr 1, 2004 Accepting new patients
Golden Valley Emergency Physicians, LLC Past Accepting new patients

Locations

1701 N 2nd St
Clinton, MO 64735
Phone (660) 885-8171

1602 N 2nd St
Clinton, MO 64735
Phone (660) 885-8171

1600 N 2nd St
Clinton, MO 64735
Phone (660) 885-8171

Organizations & group practices 4

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240963200000",
    "number": "1649247727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 N 2ND ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647351192",
            "telephone_number": "660-885-8171",
            "fax_number": "660-890-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 N 2ND ST",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647351192",
            "telephone_number": "660-885-8171",
            "fax_number": "660-890-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABBERT",
        "first_name": "TIMOTHY",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2009-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R3D43",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MO

Sources for this page

Verify at the official NPI Registry.