Active NPI
Timothy Joseph York, D.O.
- Pediatrics Physician
- Covington, VA
National Provider Identifier
1811961154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0102203160
- Practice address
- 411 W Riverside St
Covington, VA 24426-1273 - Phone
- (540) 960-2111
- Fax
- (540) 960-2117
- NPI assigned
- Feb 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 1878 | WV | |
| Pediatrics Physician | 208000000X | 0102203160 | VA | Primary |
Addresses
Primary practice location
411 W Riverside St
Covington, VA 24426-1273
Mailing address
411 W Riverside St
Covington, VA 24426-1273
Phone (540) 960-2111
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811961154 | Other | VA | ANTHEM BCBS |
| 1811961154 | Medicaid | VA | |
| 3810002348 | Medicaid | WV | |
| 1811961154 | Other | WV | HIGHMARK BCBS |
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0102203160 | VA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wvva Health Care Alliance, PC | Pediatrics | Past | Accepting new patients |
| Kelly Medical Services Corporation LLC | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Kelly Medical Corporation
- Emergency Medicine Physician
- Welch, WV
- NPI 1033154810
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373414400000",
"number": "1811961154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 W RIVERSIDE ST",
"city": "COVINGTON",
"state": "VA",
"postal_code": "244261273",
"telephone_number": "540-960-2111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 W RIVERSIDE ST",
"city": "COVINGTON",
"state": "VA",
"postal_code": "244261273",
"telephone_number": "540-960-2111",
"fax_number": "540-960-2117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YORK",
"first_name": "TIMOTHY",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-14",
"last_updated": "2013-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WV",
"license": "1878",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VA",
"license": "0102203160",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "1811961154",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1811961154",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810002348",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BCBS",
"identifier": "1811961154",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Covington, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.