Timothy Kevin Yates

Primary specialty

DriverTaxonomy code 172A00000X

License

009683723 Issued in LA

Practice address

1285 W Hawthorne Rd
Leesville, LA 71446-6052

Phone

(903) 243-3883

NPI assigned

Jul 13, 2024

Last updated

Jul 31, 2024By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Genesis Mortuary Transport LLC

  dba Genesis Transport

  • Non-emergency Medical Transport (VAN)
  • Leesville, LA
  • NPI 1497584023
  NPD Authorized official

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

{
    "created_epoch": "1720828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1902643182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 W HAWTHORNE RD",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714466052",
            "telephone_number": "903-243-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 W HAWTHORNE RD",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714466052",
            "telephone_number": "903-243-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "TIMOTHY",
        "middle_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-13",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "LA",
            "license": "009683723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serenity Suelynn Withem-Rardin
• Women's Primary Health Care, Inc.
• Woodlands Opco LLC (The Woodlands Healthcare Center)
• Shawn Michelle Wright, FNP
• Lisa Yates, MOT, LOTR
• Alyssa Young
• Lashawn Young, CT
• Marcillin Zetrenne

• Driver in Leesville, LA
• Providers in Leesville, LA by specialty
• Driver in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.