Individual provider Active NPI

Timothy D Burkam, P.T.

  • Physical Therapist
  • Marion, OH
National Provider Identifier
1699892117
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT002840 Issued in OH
Practice address
990 S Prospect St
Marion, OH 43302-6283
Phone
(740) 387-2900
Fax
(740) 387-2922
NPI assigned
Mar 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT002840 OH Primary

Addresses

Primary practice location

990 S Prospect St
Marion, OH 43302-6283

Mailing address

4652 Dunleary Dr
Dublin, OH 43017-8610
Phone (614) 582-6968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT002840OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
River Rock Rehabilitation, LLC Physical Therapist CurrentSince Dec 13, 2002 Accepting new patients
Tender Touch at Home NJ LLC Physical Therapist Past Accepting new patients

Locations

990 S Prospect St
Marion, OH 43302
Phone (740) 375-0775

Organizations & group practices 2

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699892117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4652 DUNLEARY DR",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430178610",
            "telephone_number": "614-582-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 S PROSPECT ST",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026283",
            "telephone_number": "740-387-2900",
            "fax_number": "740-387-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKAM",
        "first_name": "TIMOTHY",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT002840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.