Timothy Poole, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

04755801 Issued in NY

Practice address

5639 W Genesee St
Camillus, NY 13031-1250

Phone

(315) 565-7060

NPI assigned

Jan 10, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1689335804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 CHURCHILL LN",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130662541",
            "telephone_number": "315-751-9684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5639 W GENESEE ST",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311250",
            "telephone_number": "315-565-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "TIMOTHY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "04755801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelbie Filicia Pidkaminy, MS, NP, PMHNP-BC
• Tara Rose Pienkowski, M.S.
• Trudy H Piersall, LPN
• Bonnie Jean Pirro, PHYSICAL THERAPIST
• Podiatry Services of Central New York, PC
• Nancy Popps, NP
• Mark S Potenza, MD
• Preferred Audiology Care, LLC
• Preventive Medicine Associates LLC
• Matthew Procopio, MD

• All providers in Camillus, NY
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.