Individual provider Active NPI

Colleen P Timpane, L.C.S.W

  • Social Worker
  • Renton, WA
National Provider Identifier
1861811812
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LCS 29453 Issued in CA
Practice address
275 Bronson Way NE
Renton, WA 98056-4030
Phone
(425) 235-2800
Fax
(877) 516-9184
NPI assigned
Apr 7, 2014
Last updated
Feb 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LCS 29453 CA Primary

Addresses

Primary practice location

275 Bronson Way NE
Renton, WA 98056-4030

Mailing address

7200 Bancroft Ave Ste 125a
Oakland, CA 94605-2457
Phone (510) 777-3800

Other practice location 1

7200 Bancroft Ave Ste 125A
Oakland, CA 94605-2457
Phone (510) 777-3800

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCS 29453CAMDSocial Worker
29453CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1861811812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 BANCROFT AVE STE 125A",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052457",
            "telephone_number": "510-777-3800",
            "fax_number": "510-777-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 BRONSON WAY NE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980564030",
            "telephone_number": "425-235-2800",
            "fax_number": "877-516-9184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 Bancroft Ave Ste 125A",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946052457",
            "country_code": "US",
            "telephone_number": "510-777-3800",
            "fax_number": "510-777-3806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMPANE",
        "first_name": "COLLEEN",
        "middle_name": "P",
        "credential": "L.C.S.W",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCS 29453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "275 Bronson Way NE",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980564030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.