Active NPI
Timothy Thannisch
- Registered Nurse
- Durant, OK
National Provider Identifier
1831790005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R0067271
- Practice address
- 2425 W University Blvd Ste 100
Durant, OK 74701-2970 - Phone
- (580) 924-7331
- Fax
- (580) 924-7332
- NPI assigned
- Nov 4, 2020
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R0067271 | OK | Primary |
Addresses
Primary practice location
2425 W University Blvd Ste 100
Durant, OK 74701-2970
Mailing address
2425 W University Blvd Ste 100
Durant, OK 74701-2970
Phone (580) 924-7331
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 |
|---|---|---|---|
| R0067271 | OK | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604448000000",
"number": "1831790005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 W UNIVERSITY BLVD STE 100",
"city": "DURANT",
"state": "OK",
"postal_code": "747012970",
"telephone_number": "580-924-7331",
"fax_number": "580-924-7332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 W UNIVERSITY BLVD STE 100",
"city": "DURANT",
"state": "OK",
"postal_code": "747012970",
"telephone_number": "580-924-7331",
"fax_number": "580-924-7332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THANNISCH",
"first_name": "TIMOTHY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-04",
"last_updated": "2020-11-04",
"certification_date": "2020-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OK",
"license": "R0067271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durant, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.