Individual provider Active NPI

Timothy Whitmire, O.D.

  • Optometrist
  • Enola, PA
National Provider Identifier
1669887600
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.0003085 Issued in CO
Practice address
6943 Wertzville Rd
Enola, PA 17025-1039
Phone
(717) 645-6074
NPI assigned
Jun 29, 2014
Last updated
Oct 16, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.0003085 CO Primary
Optometrist 152W00000X OEG002943 PA

Addresses

Primary practice location

6943 Wertzville Rd
Enola, PA 17025-1039

Mailing address

6943 Wertzville Rd
Enola, PA 17025-1039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20150114001655 CO Practitioner - Optometry 0648594937 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.0003085COMDOptometrist
OEG002943PAMDOptometrist

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, 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": "1404000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413417600000",
    "number": "1669887600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6943 WERTZVILLE RD",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6943 WERTZVILLE RD",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251039",
            "telephone_number": "717-645-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITMIRE",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-29",
        "last_updated": "2014-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003085",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG002943",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enola, PA

Sources for this page

Verify at the official NPI Registry.