Timothy K Massengill

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160002132 Issued in NU

Practice address

505 Stevens St
Nokomis, IL 62075-1442

Phone

(217) 563-7725

NPI assigned

Nov 24, 2021

Last updated

Nov 24, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1902563943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 LOCUST AVE",
            "city": "NEOGA",
            "state": "IL",
            "postal_code": "624471404",
            "telephone_number": "217-419-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 STEVENS ST",
            "city": "NOKOMIS",
            "state": "IL",
            "postal_code": "620751442",
            "telephone_number": "217-563-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSENGILL",
        "first_name": "TIMOTHY",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-24",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": "160002132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Nokomis, IL
• Providers in Nokomis, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; 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.