Timothy J Stallman

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101009145 Issued in MI

Practice address

16523 S Watertower Dr
Kincheloe, MI 49719

Phone

(906) 495-3030

Fax

(906) 495-3035

NPI assigned

Sep 5, 2006

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

• Dr. Timothy J Stallman Professional name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720181068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 MAPLE POINT RD",
            "city": "PICKFORD",
            "state": "MI",
            "postal_code": "49719",
            "telephone_number": "906-647-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16523 S WATERTOWER DR",
            "city": "KINCHELOE",
            "state": "MI",
            "postal_code": "49719",
            "telephone_number": "906-495-3030",
            "fax_number": "906-495-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STALLMAN",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101009145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIMOTHY",
            "last_name": "STALLMAN",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• All providers in Kincheloe, MI
• Family Medicine Physician in Michigan

• 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.