Individual provider Active NPI

Timothy Sheahan, DPM

  • Podiatrist
  • Elmira, NY
National Provider Identifier
1760464788
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N0029891 Issued in NY
Practice address
446 E Water Street
Elmira, NY 14901-3411
Phone
(607) 734-6006
Fax
(607) 734-4036
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N0029891 NY Primary

Addresses

Primary practice location

446 E Water Street
Elmira, NY 14901-3411

Mailing address

446 E Water Street
Elmira, NY 14901-3411
Phone (607) 734-6006

Other identifiers 1

IdentifierTypeStateIssuer
00421352MedicaidNY

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

State licenses

LicenseStateTypeSpecialty
N0029891NYMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1760464788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 E WATER STREET",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013411",
            "telephone_number": "607-734-6006",
            "fax_number": "607-734-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 E WATER STREET",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013411",
            "telephone_number": "607-734-6006",
            "fax_number": "607-734-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEAHAN",
        "first_name": "TIMOTHY",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N0029891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00421352",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.