Timothy J Lord, ARNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP30004092 Issued in WA

Practice address

560 Gage Blvd Ste 102
Kadlec Clinic Senior Health Clinic
Richland, WA 99352

Phone

(509) 942-3135

Fax

(509) 627-1188

NPI assigned

Jun 1, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1699094623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 GAGE BLVD",
            "address_2": "STE 203",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "99352",
            "telephone_number": "509-942-3627",
            "fax_number": "509-942-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 GAGE BLVD STE 102",
            "address_2": "KADLEC CLINIC SENIOR HEALTH CLINIC",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "99352",
            "telephone_number": "509-942-3135",
            "fax_number": "509-627-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORD",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-01",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP30004092",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201050071NP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON LICENSE",
            "identifier": "201050071NP",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Richland, WA
• Providers in Richland, WA by specialty
• Gerontology Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; 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.