Individual provider Active NPI

Timothy Jay Brown, D.P.M.

  • Podiatrist
  • Marion, OH
National Provider Identifier
1649249749
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36-002003 Issued in OH
Practice address
1051 Harding Memorial Pkwy
Suite B
Marion, OH 43302-6347
Phone
(740) 383-5115
Fax
(740) 387-3668
NPI assigned
Mar 14, 2006
Last updated
Mar 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36-002003 OH Primary

Addresses

Primary practice location

1051 Harding Memorial Pkwy
Suite B
Marion, OH 43302-6347

Mailing address

1051 Harding Memorial Pkwy
Suite B
Marion, OH 43302-6347
Phone (740) 383-5115

Other identifiers 1

IdentifierTypeStateIssuer
0481447MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090215000002 OH Practitioner - Podiatry 9830173129 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2003OHMDChiropractor
36-002003OHMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ankle and Foot Specialists of Marion, Inc Podiatrist CurrentSince Mar 15, 2008 Accepting new patients
Marion Regional Cancer Center PastSince Apr 12, 2005 Accepting new patients
Marion Independent Physicians Association, LLC Podiatrist PastSince Jul 4, 2021 Accepting new patients

Locations

6200 Pleasant Ave
Ste 3
Fairfield, OH 45014
Phone (513) 745-9988

1051 Harding Memorial Pkwy
Marion, OH 43302
Phone (740) 383-5115

1051 Harding Memorial Pkwy
Ste B
Marion, OH 43302
Phone (740) 383-5115

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EAFGDD

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1649249749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 HARDING MEMORIAL PKWY",
            "address_2": "SUITE B",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026347",
            "telephone_number": "740-383-5115",
            "fax_number": "740-387-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 HARDING MEMORIAL PKWY",
            "address_2": "SUITE B",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026347",
            "telephone_number": "740-383-5115",
            "fax_number": "740-387-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TIMOTHY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36-002003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0481447",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.