Active NPI
Timothy William Walkowiak, NP-C
- Family Nurse Practitioner
- Phoenix, AZ
National Provider Identifier
1841887270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- TEMP251658
- Practice address
- 9020 W Thomas Rd
Phoenix, AZ 85037-3234 - Phone
- (602) 889-9401
- Fax
- (602) 889-9404
- NPI assigned
- Dec 31, 2020
- Last updated
- Dec 31, 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | TEMP251658 | AZ | Primary |
Addresses
Primary practice location
9020 W Thomas Rd
Phoenix, AZ 85037-3234
Mailing address
4220 N 20TH Ave
Phoenix, AZ 85015-5124
Phone (602) 889-9401
Other practice location 1
4220 N 20th Ave
Phoenix, AZ 85015-5124
Phone (602) 889-9401
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 |
|---|---|---|---|
| TEMP251658 | AZ | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| I Am Wellness Az LLC | Past | Accepting new patients | |
| I Am Wellness Az LLC | Past | Accepting new patients | |
| I Am Wellness Az LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Chandler, AZ
- NPI 1184354532
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609372800000",
"number": "1841887270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4220 N 20TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850155124",
"telephone_number": "602-889-9401",
"fax_number": "602-889-9404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9020 W THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850373234",
"telephone_number": "602-889-9401",
"fax_number": "602-889-9404"
}
],
"practiceLocations": [
{
"address_1": "4220 N 20th Ave",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850155124",
"country_code": "US",
"telephone_number": "602-889-9401",
"fax_number": "602-889-9404",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WALKOWIAK",
"first_name": "TIMOTHY",
"middle_name": "WILLIAM",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-31",
"last_updated": "2020-12-31",
"certification_date": "2020-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AZ",
"license": "TEMP251658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.