Timothy J. Tobolic, MD, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301038030 Issued in MI

Legal business name

TIMOTHY J. TOBOLIC, MD, PLLC

Practice address

7740 Byron Center Ave SW
Suite 202
Byron Center, MI 49315-6928

Phone

(616) 217-5100

Fax

(616) 217-5105

NPI assigned

May 20, 2010

Organization subpart

No

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

Authorized official

Name

Timothy Tobolic, MDNPI 1013940584

Title

Owner

Phone

(616) 334-3374

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Joseph Tobolic, M.D.

  • Family Medicine Physician
  • Byron Center, MI
  • NPI 1013940584

  MI

  Medicare reassignment Care Compare group Authorized official
• Scott Duemler, MD

  • Family Medicine Physician
  • Byron Center, MI
  • NPI 1306898036

  Family Medicine, MI

  Medicare reassignment Care Compare group NPD
• Lynh Kayser

  • Pharmacist
  • Byron Center, MI
  • NPI 1265092886
  NPD (past)

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

{
    "created_epoch": "1274313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1982923660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7740 BYRON CENTER AVE SW",
            "address_2": "SUITE 202",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493156928",
            "telephone_number": "616-217-5100",
            "fax_number": "616-217-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7740 BYRON CENTER AVE SW",
            "address_2": "SUITE 202",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493156928",
            "telephone_number": "616-217-5100",
            "fax_number": "616-217-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY J. TOBOLIC, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-20",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "TOBOLIC",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-334-3374",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301038030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Tetreault-Blok
• Ashley Theeuwes
• Third Coast Oral & Maxillofacial Surgery
• Kelly Renee Thornton, D.C.
• Ryan D Thornton, D.C.
• Kaitlyn Marie Tobeler, LLBSW QIDP
• Timothy Joseph Tobolic, M.D.
• Thaovy Mai Tran, RPH
• Caitlin Trezise
• Trilogy Healthcare of Kent LLC

• All providers in Byron Center, MI
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.