Individual provider Active NPI

Timothy D Semple, CRNA

  • Certified Registered Nurse Anesthetist
  • Leonardtown, MD
National Provider Identifier
1730152224
Registry record updated Nov 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R143440 Issued in MD
Practice address
25500 Point Lookout Rd
Leonardtown, MD 20650
Phone
(301) 475-6204
Fax
(301) 997-6507
NPI assigned
Feb 7, 2006
Last updated
Nov 6, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 28119695 IN
Certified Registered Nurse Anesthetist 367500000X R143440 MD Primary

Addresses

Primary practice location

25500 Point Lookout Rd
Leonardtown, MD 20650

Mailing address

25500 Point Lookout Rd
Box 527
Leonardtown, MD 20650
Phone (301) 475-6204

Other identifiers 2

IdentifierTypeStateIssuer
206403100MedicaidMD
430051192OtherMDMEDICARE RAILROAD

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
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
28119695INMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Newbridge Surgery Center at Prince Frederick, LLC Past Accepting new patients
Newbridge Anesthesia LLC PastSince Aug 27, 2019 Accepting new patients

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": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1730152224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 POINT LOOKOUT RD",
            "address_2": "BOX 527",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "20650",
            "telephone_number": "301-475-6204",
            "fax_number": "301-997-6507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 POINT LOOKOUT RD",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "20650",
            "telephone_number": "301-475-6204",
            "fax_number": "301-997-6507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMPLE",
        "first_name": "TIMOTHY",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28119695",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R143440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206403100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "430051192",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; 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.