Timothy J Halloran, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

273301 Issued in MN

Practice address

500 N Main St
Suite 101
Le Sueur, MN 56058-5500

Phone

(507) 665-4017

Fax

(507) 665-4019

NPI assigned

Jan 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: thalloran90180@ehrdirect.mayoclinicmsg.org

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1831249481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W PRAIRIE ST",
            "city": "BELLE PLAINE",
            "state": "MN",
            "postal_code": "560111000",
            "telephone_number": "952-873-2276",
            "fax_number": "952-873-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N MAIN ST",
            "address_2": "SUITE 101",
            "city": "LE SUEUR",
            "state": "MN",
            "postal_code": "560585500",
            "telephone_number": "507-665-4017",
            "fax_number": "507-665-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLORAN",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "273301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226268100",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thalloran90180@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "500 N Main St",
            "address_2": "Suite 101",
            "city": "Le Sueur",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560585500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Family Medicine Physician in Le Sueur, MN
• Providers in Le Sueur, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.