Active NPI
Kyle Timmerman, MD
- Internal Medicine Physician
- Overland Park, KS
National Provider Identifier
1902333818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 04-20188
- Practice address
- 10504 Cody St Apt 98
Overland Park, KS 66214-2734 - Phone
- (913) 894-2931
- Fax
- (913) 894-2931
- NPI assigned
- May 23, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 04-20188 | KS | Primary |
Addresses
Primary practice location
10504 Cody St Apt 98
Overland Park, KS 66214-2734
Mailing address
10504 Cody St Apt 98
Overland Park, KS 66214-2734
Phone (913) 894-2931
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-20188 | KS | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1902333818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10504 CODY ST APT 98",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662142734",
"telephone_number": "913-894-2931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10504 CODY ST APT 98",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662142734",
"telephone_number": "913-894-2931",
"fax_number": "913-894-2931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIMMERMAN",
"first_name": "KYLE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-05-23",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "KS",
"license": "04-20188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.