Active NPI
Timothy J McInnis, MD
- Ophthalmology Physician
- Bozeman, MT
National Provider Identifier
1942299763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 7094
- Practice address
- 300 N Willson Ave
Ste 1003
Bozeman, MT 59715-3551 - Phone
- (406) 587-1245
- Fax
- (406) 587-1092
- NPI assigned
- Oct 14, 2005
- Last updated
- Sep 21, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 7094 | MT | Primary |
Addresses
Primary practice location
300 N Willson Ave
Ste 1003
Bozeman, MT 59715-3551
Mailing address
300 N Willson Ave
Ste 1003
Bozeman, MT 59715-3551
Phone (406) 587-1245
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 98293 | Medicaid | MT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7094 | MT | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christopher L Paris M D P C | Past | Accepting new patients | |
| Medical Eye Specialists PC | Ophthalmology | Past | Accepting new patients |
| Same Day Surgery Center | Past | Accepting new patients | |
| Starlyn Green Inc. | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Specialist
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- NPI 1003975269
-
- Ophthalmology Physician
- Bozeman, MT
- NPI 1093704108
-
- Ambulatory Surgical Clinic/Center
- Bozeman, MT
- NPI 1487684213
-
- Certified Registered Nurse Anesthetist
- Bozeman, MT
- NPI 1811293764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190332800000",
"number": "1942299763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 N WILLSON AVE",
"address_2": "STE 1003",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597153551",
"telephone_number": "406-587-1245",
"fax_number": "406-587-1092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 N WILLSON AVE",
"address_2": "STE 1003",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597153551",
"telephone_number": "406-587-1245",
"fax_number": "406-587-1092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINNIS",
"first_name": "TIMOTHY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-14",
"last_updated": "2007-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MT",
"license": "7094",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "98293",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bozeman, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.