Active NPI
Timothy J Pafford, CADC
- Addiction (Substance Use Disorder) Counselor
- Atlantic, IA
National Provider Identifier
1972967495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 16058
- Practice address
- 1500 E 10TH St
Atlantic, IA 50022-1935 - Phone
- (712) 243-5091
- Fax
- (712) 243-1337
- NPI assigned
- Apr 11, 2016
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16058 | IA | Primary |
Addresses
Primary practice location
1500 E 10TH St
Atlantic, IA 50022-1935
Mailing address
1500 E 10TH St
Atlantic, IA 50022-1935
Phone (712) 243-5091
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 68236 | Other | IA | WELLMARK |
| 0177394 | Medicaid | IA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16058 | IA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460332800000",
"number": "1972967495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 E 10TH ST",
"city": "ATLANTIC",
"state": "IA",
"postal_code": "500221935",
"telephone_number": "712-243-5091",
"fax_number": "712-243-1337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E 10TH ST",
"city": "ATLANTIC",
"state": "IA",
"postal_code": "500221935",
"telephone_number": "712-243-5091",
"fax_number": "712-243-1337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAFFORD",
"first_name": "TIMOTHY",
"middle_name": "J",
"credential": "CADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-11",
"last_updated": "2016-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IA",
"license": "16058",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "68236",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0177394",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Atlantic, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.