Organization Active NPI

Timothy G McNally DO PC

  • Ophthalmology Physician
  • Burton, MI
National Provider Identifier
1760795801
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
TM012077 Issued in MI
Legal business name
TIMOTHY G MCNALLY DO PC
Practice address
3364 S Center Rd
Burton, MI 48519-1458
Phone
(810) 743-3937
Fax
(810) 743-9210
NPI assigned
Jul 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Authorized official

Name
Brenda K Vowell
Title
Biller
Phone
(989) 666-6135

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X TM012077 MI Primary

Addresses

Primary practice location

3364 S Center Rd
Burton, MI 48519-1458

Mailing address

3364 S Center Rd
Burton, MI 48519-1458
Phone (810) 743-3937

Other identifiers 2

IdentifierTypeStateIssuer
3391829MedicaidMI
0B50586OtherMIBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101208000988 MI Part B Supplier - Clinic/Group Practice 9335353291 Receives reassigned benefits from 2 practitioners
Practice locations: Burton, MI

National Provider Directory

National Provider Directory

Locations

3364 S Center Rd
Burton, MI 48519
Phone (810) 743-3937

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762214400000",
    "number": "1760795801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3364 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191458",
            "telephone_number": "810-743-3937",
            "fax_number": "810-743-9210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3364 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191458",
            "telephone_number": "810-743-3937",
            "fax_number": "810-743-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY G MCNALLY DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-19",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A",
        "authorized_official_last_name": "VOWELL",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "989-666-6135"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "TM012077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3391829",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0B50586",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.