TIMOTHY WAYNE CORK (NPI# 1174000566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174000566 |
| Entity Type | Individual |
| Full Name | TIMOTHY WAYNE CORK |
| Credential | CPRP, BS |
| Practice Address |
2201 Ironwood Pl Coeur D Alene ID 83814-2670 |
| Practice Telephone | 2087694222 |
| Practice Fax Number | 2087710628 |
| Mailing Telephone | 2087694222 |
| Mailing Fax Number | 2087710628 |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2018-07-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
2201 IRONWOOD PL |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-2670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336182112 | Tracey L Sutton | Social Worker | 2201 Ironwood Pl, Coeur D Alene, ID 83814-2670 | 2006-06-13 |
| 1790252526 | Amanda R Bailey | Rehabilitation Practitioner | 2201 Ironwood Pl, Coeur D Alene, ID 83814-2670 | 2018-10-30 |
| 1811463771 | Kristian Leigh Carson | Rehabilitation Practitioner | 2201 Ironwood Pl, Coeur D Alene, ID 83814-2670 | 2018-10-18 |
| 1902372857 | Luis Esteban Chavolla | Rehabilitation Practitioner | 2201 Ironwood Pl, Coeur D Alene, ID 83814-2670 | 2018-10-18 |
| 1184103335 | Shauna Rae Herman | Rehabilitation Practitioner | 2201 Ironwood Pl, Coeur D Alene, ID 83814-2670 | 2018-08-08 |
| 1073091864 | Sally Jo Fischer | Community Health Worker | 2201 Ironwood Pl, Coeur D Alene, ID 83814-2670 | 2018-08-02 |
| 1275010233 | Gordon Bruce Cuthbert | Peer Specialist | 2201 Ironwood Pl, Coeur D Alene, ID 83814-2670 | 2018-07-23 |
| 1679059208 | Tina Marie Rozniewski | Peer Specialist | 2201 Ironwood Pl, Coeur D Alene, ID 83814-2670 | 2018-07-17 |
| 1962988451 | Cassey Coleman | Peer Specialist | 2201 Ironwood Pl, Coeur D Alene, ID 83814-2670 | 2018-07-17 |
| 1073099719 | Erica Marie Blessing I | Social Worker | 2201 Ironwood Pl, Coeur D Alene, ID 83814-2670 | 2018-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
| 1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| Find all providers in zip 83814 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740249275 | Daryl K Maccarter | Specialist | 950 W Ironwood Dr, Coeur D Alene, ID 83814-2644 | 2006-03-22 |
| 1326034430 | Jonathan S King | Specialist | 850 W Ironwood Dr Ste 202, Coeur D Alene, ID 83814-4903 | 2005-09-23 |
| 1467448860 | Lloyd E. Witham | Specialist | 1107 W Ironwood Dr, Coeur D Alene, ID 83814-2604 | 2005-09-21 |
| 1952772196 | Gayle Dohrman | Specialist | 2195 Ironwood Ct, Coeur D Alene, ID 83814-2628 | 2015-10-14 |
| 1740539725 | Gregory R. Keese, M.d., P.C. | Specialist | 1107 W Ironwood Dr, Coeur D Alene, ID 83814-2604 | 2012-09-05 |
| 1619278082 | Kala Marie Moore | Specialist | 852 W Kathleen Ave, Coeur D Alene, ID 83815-9405 | 2010-11-16 |
| 1700107612 | Jill Peterson | Specialist | 6125 N Sunshine St, Coeur D Alene, ID 83815 | 2010-06-15 |
| 1003050527 | Peter C Jones Md Pa | Specialist | 2121 W Ironwood Center Dr, Coeur D Alene, ID 83814-2639 | 2009-04-28 |
| 1013184837 | Maryanne Kleven | Specialist | 500 W Aqua Ave, Coeur D Alene, ID 83815-7764 | 2008-05-12 |
| 1316137862 | Gregory R Keese | Specialist | 1107 W Ironwood Dr, Coeur D Alene, ID 83814-2604 | 2007-07-31 |
| Find all providers in COEUR D ALENE | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
Please comment or provide details below to improve the information on TIMOTHY WAYNE CORK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.