Ellison J Timmer, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704260596 Issued in MI

Practice address

12460 Riley St
Holland, MI 49424-8217

Phone

(616) 399-6500

Fax

(616) 399-1908

NPI assigned

Feb 1, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ellison J Klaasen Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cancer and Hematology Centers of Western Mi, P.C.Group PAC ID 4082526793, 109 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

96

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Cancer & Hematology Centers of Western Mi, P.C.

  • Specialist
  • Grand Rapids, MI
  • NPI 1528018389
  Medicare reassignment Care Compare group NPD
• Cancer & Hematology Centers of Western Mi, P.C.

  • Community/Retail Pharmacy
  • Norton Shores, MI
  • NPI 1316197379
  NPD (past)

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1982976304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 FOREMOST DR SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467062",
            "telephone_number": "616-954-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12460 RILEY ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248217",
            "telephone_number": "616-399-6500",
            "fax_number": "616-399-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMMER",
        "first_name": "ELLISON",
        "middle_name": "J",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-01",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704260596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLISON",
            "last_name": "KLAASEN",
            "middle_name": "J",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Karleena Ann Tillottson, LMSW
• Melissa Sue Timmer
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• Ashley Todd, WHNP-BC

• Family Nurse Practitioner in Holland, MI
• Providers in Holland, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.