Timothy Peter Clare, M.D.

Key facts

NPI

1861469876

Entity type

Individual (NPI type 1)

Primary specialty

Family Medicine Physician 207Q00000X

License

35-05-1719 (OH)

Practice address

40 White Oak
Professional Center
Vincent, OH 45784-5638

Phone

(740) 678-2374

Fax

(740) 678-8139

NPI assigned

Mar 8, 2006

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 2, 2011.

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1861469876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457500449",
            "telephone_number": "740-374-4500",
            "fax_number": "740-374-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 WHITE OAK",
            "address_2": "PROFESSIONAL CENTER",
            "city": "VINCENT",
            "state": "OH",
            "postal_code": "457845638",
            "telephone_number": "740-678-2374",
            "fax_number": "740-678-8139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARE",
        "first_name": "TIMOTHY",
        "middle_name": "PETER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-05-1719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0591417",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000699780",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0053963000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000678715",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vincent, OH

• Jared Carney, DO
• Larry Cassady
• Micah Christian
• Nicolette Christian
• Taylor Christopher
• Roxanne E Cline, QMHS
• Hallie Alexis Cochran, PT, DPT
• Denise Cross, QMHS
• Regan Curry
• Lloyd Dennis, M.D.

All providers in Vincent, OH · Family Medicine Physician in Ohio