NPIMap

Individual provider Active NPI

Nicholas Storm Timmerwilke, MD

  • Emergency Medicine Physician
  • Springfield, MO
National Provider Identifier
1780144691
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2022012028 Issued in MO
Practice address
1235 E Cherokee St
Springfield, MO 65804-2203
Phone
(417) 820-2115
NPI assigned
Mar 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 2022012028 MO Primary

Addresses

Primary practice location

1235 E Cherokee St
Springfield, MO 65804-2203

Mailing address

1235 E Cherokee St
Springfield, MO 65804-2203
Phone (417) 820-2115

Other practice location 1

3100 N Tenaya Way
Las Vegas, NV 89128-0436
Phone (702) 962-9551

Other practice location 2

100 Hospital Dr
Lebanon, MO 65536-9210
Phone (417) 533-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220811002485 MO Practitioner - Emergency Medicine 1052641388 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Missouri, Columbia School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians
Mercy Hospital SpringfieldGroup PAC ID 7416867593, 54 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203
Phone (417) 820-2600

Hospital & facility affiliations

  • Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065
  • Mercy Hospital Lebanon Hospital, Lebanon, MO, CCN 260059

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Nov 18, 2025 Accepting new patients
Mercy St. Francis Hospital CurrentSince Apr 11, 2023 Accepting new patients
Mercy Hospital Aurora CurrentSince Apr 11, 2023 Accepting new patients
Mercy St. Francis Hospital Current Accepting new patients
Mercy Hospital Aurora CurrentSince Apr 11, 2023 Accepting new patients
Mercy Hospital Cassville CurrentSince Apr 11, 2023 Accepting new patients
Mercy Hospital Springfield CurrentSince Aug 1, 2022 Accepting new patients
Mercy Hospital Springfield CurrentSince Aug 1, 2022 Accepting new patients
Mercy Hospital Cassville CurrentSince Apr 11, 2023 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Nov 18, 2025 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Nov 18, 2025 Accepting new patients

Locations

500 Porter Ave
Aurora, MO 65605
Phone (417) 678-2122

94 Main St
Cassville, MO 65625
Phone (417) 782-7722

90 Gravel St
Cassville, MO 65625
Phone (417) 847-6000

100 Hospital Dr
Lebanon, MO 65536
Phone (417) 533-6010

100 W US Highway 60
Mountain View, MO 65548
Phone (417) 934-7000

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1780144691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-2115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 N Tenaya Way",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891280436",
            "country_code": "US",
            "telephone_number": "702-962-9551",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "MO",
            "postal_code": "655369210",
            "country_code": "US",
            "telephone_number": "417-533-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMMERWILKE",
        "first_name": "NICHOLAS",
        "middle_name": "STORM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2022012028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.