Timothy St John, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

TS001531 Issued in MI

Practice address

3179 W Houghton Lake Dr
Houghton Lake, MI 48629-9256

Phone

(989) 366-8332

NPI assigned

Dec 24, 2005

Last updated

Jan 4, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Timothy C St. John II

  dba Houghton Lake Foot Clinic

  • Podiatrist
  • Houghton Lake, MI
  • NPI 1780661322
  Authorized official Same address or phone
• Tawas Foot Clinic

  • Durable Medical Equipment & Medical Supplies
  • Tawas City, MI
  • NPI 1053616870
  NPD (past)
• Tawas Foot Clinic P.C.

  • Primary Podiatric Medicine Podiatrist
  • Tawas City, MI
  • NPI 1528094489
  NPD (past)

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

{
    "created_epoch": "1135382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1871570416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 LEONARD ST NW",
            "address_2": "SUITE 103",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "495348447",
            "telephone_number": "616-453-6329",
            "fax_number": "616-453-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3179 W HOUGHTON LAKE DR",
            "city": "HOUGHTON LAKE",
            "state": "MI",
            "postal_code": "486299256",
            "telephone_number": "989-366-8332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST JOHN",
        "first_name": "TIMOTHY",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-24",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "TS001531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3119585",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Serenity Sleep Center, LLC
• Roxanne Shudark
• Rachel Simpson, RN
• Lauren Elizabeth Skarnulis, O.D.
• Ruth N Spalding, LMSW
• June Ann Stefanko, FNP
• C J Strausbaugh, PA
• Gregory Stuck, D.C.
• Donald Lenard Sylvester, A.C.M.T.
• Summer Elise Tambs, LMSW-CLINICAL

• Podiatrist in Houghton Lake, MI
• Providers in Houghton Lake, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.