Individual provider Active NPI

Timothy C Flynn, MD

  • Vascular Surgery Physician
  • Gainesville, FL
National Provider Identifier
1972530822
Registry record updated Feb 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
ME44679 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone
(352) 265-0152
Fax
(352) 265-8966
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X ME44679 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3003

Mailing address

PO Box 918025
Orlando, FL 32891-8025

Other names 1

  • Timothy Carlyle Flynn Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803000259 FL Practitioner - Vascular SurgeryPractitioner - General Surgery 1254464803 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jun 1, 1984 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jun 1, 1984 Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203292800000",
    "number": "1972530822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328918025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-265-0152",
            "fax_number": "352-265-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "TIMOTHY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2008-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME44679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIMOTHY",
            "last_name": "FLYNN",
            "middle_name": "CARLYLE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.