John Robbie Tisdall, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

16303 Issued in WA

Practice address

1815 C Street
Suite J35
Bellingham, WA 98225-4027

Phone

(360) 671-7017

Fax

(360) 671-7099

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1740360833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 C STREET",
            "address_2": "SUITE J35",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254027",
            "telephone_number": "360-671-7017",
            "fax_number": "360-671-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 C STREET",
            "address_2": "SUITE J35",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254027",
            "telephone_number": "360-671-7017",
            "fax_number": "360-671-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALL",
        "first_name": "JOHN",
        "middle_name": "ROBBIE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "16303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1096031",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sophie Shoshanna Timin
• April K Tinker
• Brenda Kay Tinklenberg, BA
• Kevin Douglas Tinsley
• Jennifer Louise Tippie Quesada, CD
• Heather Dawn Tiszai, MA, LMHC, NCC
• Ann Eleanor Tive, LM
• Eric Tkacsik, D.C.
• Latisha N Toby, CPC
• Stephanie D Toby, CG

• Ophthalmology Physician in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Ophthalmology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.