Individual provider Active NPI

Alan L. Tims, M.D.

  • Colon & Rectal Surgery Physician
  • Sartell, MN
National Provider Identifier
1871561720
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
26883 Issued in MN
Practice address
2251 Connecticut Avenue S
HP Central MN Clinics
Sartell, MN 56377-2486
Phone
(320) 253-5220
Fax
(320) 203-2113
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 26883 MN Primary

Addresses

Primary practice location

2251 Connecticut Avenue S
HP Central MN Clinics
Sartell, MN 56377-2486

Mailing address

8170 33Rd Ave S
Ms21110Q
Minneapolis, MN 55425-4516
Phone (952) 883-5375

Other identifiers 3

IdentifierTypeStateIssuer
1423031OtherMEDICA
361208200MedicaidMN
40022TIOtherMNBCBSM

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26883MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Imaging Services, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339718400000",
    "number": "1871561720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "952-883-5375",
            "fax_number": "320-203-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 CONNECTICUT AVENUE S",
            "address_2": "HP CENTRAL MN CLINICS",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772486",
            "telephone_number": "320-253-5220",
            "fax_number": "320-203-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMS",
        "first_name": "ALAN",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2012-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MN",
            "license": "26883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "1423031",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "361208200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "40022TI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.