Individual provider Active NPI

Timothy P Brophy, APRN-CNP

  • Acute Care Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1790338523
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN.CNP.025193 Issued in OH
Practice address
460 W 10TH Ave
Columbus, OH 43210-1240
Phone
(614) 685-3196
Fax
(614) 293-4812
NPI assigned
Jul 21, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN.CNP.025193 OH Primary

Addresses

Primary practice location

460 W 10TH Ave
Columbus, OH 43210-1240

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 685-3196

Other practice location 1

110 N Main St Ste 350
Dayton, OH 45402-3735
Phone (937) 499-8263

Other practice location 2

122 Wyoming St
Dayton, OH 45409
Phone (937) 223-4461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190910000164 OH Practitioner - Nurse Practitioner 9830428366 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.025193OHMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc CurrentSince Sep 30, 2019 Accepting new patients
Osu Internal Medicine, LLC CurrentSince Nov 1, 2020 Accepting new patients
Premier Health Specialists Inc CurrentSince Sep 30, 2019 Accepting new patients

Locations

460 W 10th Ave
Columbus, OH 43210
Phone (614) 293-3196

410 W 10th Ave
Columbus, OH 43210
Phone (614) 293-5905

700 Ackerman Rd
Ste 2120
Columbus, OH 43202

122 Wyoming St
Dayton, OH 45409
Phone (937) 438-8640

3900 Stoneridge Ln
Dublin, OH 43017
Phone (614) 366-5001

3170 Kettering Blvd
Bldg B3
Moraine, OH 45439
Phone (937) 991-3188

3170 Kettering Blvd
Bldg 3B
Moraine, OH 45439

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1563667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1790338523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-685-3196",
            "fax_number": "614-293-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-685-3196",
            "fax_number": "614-293-4812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 N Main St Ste 350",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454023735",
            "country_code": "US",
            "telephone_number": "937-499-8263",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "122 Wyoming St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "45409",
            "country_code": "US",
            "telephone_number": "937-223-4461",
            "fax_number": "937-449-7603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROPHY",
        "first_name": "TIMOTHY",
        "middle_name": "P",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-21",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.025193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.