Active NPI
Tim Thomas
- Contractor
- Burnsville, MN
National Provider Identifier
1801559208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 1021
- Practice address
- 13208 Walnut Dr
Burnsville, MN 55337-3840 - Phone
- (651) 681-4543
- NPI assigned
- Oct 21, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 1021 | MN | Primary |
Addresses
Primary practice location
13208 Walnut Dr
Burnsville, MN 55337-3840
Mailing address
13208 Walnut Dr
Burnsville, MN 55337-3840
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | OTHER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1021 | MN | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790640000000",
"number": "1801559208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13208 WALNUT DR",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553373840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13208 WALNUT DR",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553373840",
"telephone_number": "651-681-4543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "TIM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-21",
"last_updated": "2026-09-29",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "MN",
"license": "1021",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "OTHER",
"affiliation": "N",
"address_1": "13208 Walnut Dr",
"city": "Burnsville",
"state": "MN",
"country_code": "US",
"postal_code": "553373840",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Burnsville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.