Physician Compare National (NPI:1881857951)

HEALTHCARE PROVIDER: TIMOTHY CASPERSON DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1881857951
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6507931698
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080825000536
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CASPERSON
	Individual professional last name
Provider First Name	TIMOTHY
	Individual professional first name
Provider Middle Name	C.
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	CALIFORNIA SCHOOL OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	100 MEDICAL CTR BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 216
	Group Practice or individual's line 2 address
City	CONROE
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	773042821
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9367569191
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450347
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HUNTSVILLE MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	670093
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ASPIRE BEHAVIORAL HEALTH OF CONROE, LLC
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450222
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	CONROE REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y