Timothy Leigh Patterson, D.O.
Individual provider Active NPI Psychiatry Physician · Apple Valley, MN
NPI 1710993191 · NPPES record last updated Jul 1, 2008
Key facts
- NPI
- 1710993191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 48011 (MN)
- Practice address
- 7300 147TH St W
Suite 204
Apple Valley, MN 55124-7541 - Phone
- (952) 997-3020
- Fax
- (952) 997-3026
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Support Services Inc. | Past | Accepting new patients | |
| Medcentral Professional Association Inc. | Past | Accepting new patients | |
| Nystrom & Associates, LTD | Past |
Accepting new patients | |
| Medcentral Professional Foundation, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 48011 | MN | Yes |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 48011 | MN |
Addresses
Primary practice location
7300 147TH St W
Suite 204
Apple Valley, MN 55124-7541
Mailing address
1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786
Phone (651) 628-9566
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 973108300 | Medicaid | MN |
Other providers in Apple Valley, MN
- Robin Marie Parker
- Shannon Jo Parkos
- Fernando J Partida Ruessga
- Jeffrey A Pastir
- Shuchi Patel
- Pavlik Mental Health
- PDG, P.a
- PDG, P.a.
- PDG, P.a.
- Kymn M Peacock
All providers in Apple Valley, MN · Psychiatry Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.