Individual provider Active NPI

Tim William Horton, APRN, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Woodbury, MN
National Provider Identifier
1700551504
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
8321 Issued in MN
Practice address
652 Bielenberg Dr Ste 202
Woodbury, MN 55125-4480
Phone
(651) 317-3902
Fax
(833) 972-4801
NPI assigned
Aug 12, 2021
Last updated
Aug 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 8321 MN Primary

Addresses

Primary practice location

652 Bielenberg Dr Ste 202
Woodbury, MN 55125-4480

Mailing address

652 Bielenberg Dr Ste 202
Woodbury, MN 55125-4480
Phone (651) 317-3902

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211122000216 MN Practitioner - Nurse Practitioner 3971992561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peoplefirst Clinic PLLCGroup PAC ID 4385082700, 4 clinicians

Practice addresses (Care Compare)

652 Bielenberg Dr
Suite 202
Woodbury, MN 55125-4480
Phone (651) 317-3902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8321MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aris Behavioral Health LLC CurrentSince Oct 5, 2021 Accepting new patients
Peoplefirst Clinic PLLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

2040 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 259-9750

652 Bielenberg Dr
Ste 202
Woodbury, MN 55125
Phone (651) 317-3902

724 Bielenberg Dr
Woodbury, MN 55125
Phone (612) 708-1676

Interoperability endpoints

  • Direct secure messaging: tim.horton.1@30927.direct.athenahealth.com

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": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1700551504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 BIELENBERG DR STE 202",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254480",
            "telephone_number": "651-317-3902",
            "fax_number": "833-972-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 BIELENBERG DR STE 202",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254480",
            "telephone_number": "651-317-3902",
            "fax_number": "833-972-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORTON",
        "first_name": "TIM",
        "middle_name": "WILLIAM",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-12",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MN",
            "license": "8321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.