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DR. TIMOTHY EDWARD NISSEN DO
NPI 1114480217
Pediatrics - Pediatric Cardiology in Little Rock, AR

Active since April 08, 2019PECOS EnrolledAccepts Medicare Assignment
1 CHILDRENS WAY # 512-19A, LITTLE ROCK, AR 72202(501) 364-1874 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Aug 14, 2025, Apr 8, 2019 (2 updates tracked since 2019).

About Dr. Timothy Edward Nissen Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TIMOTHY EDWARD NISSEN DO (NPI 1114480217) is an individual pediatric cardiology provider in Little Rock, Arkansas, licensed in Arkansas (E-15736) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in Little Rock, and is a graduate of Oklahoma State University College Of Osteopathic Medicine (2019).

NPPES Registry Identity

NPI1114480217
Entity TypeIndividualMale
Primary Taxonomy2080P0202X
Provider Legal NameDR. TIMOTHY EDWARD NISSENCredential: DO
Location Address1 CHILDRENS WAY # 512-19ALittle Rock, AR 72202-3500
Mailing Address4019 Valley View DrLittle Rock, AR 72212-2097 · (501) 993-3373
Phone(501) 364-1874
Sole ProprietorNo
Medical School CMSOklahoma State University College Of Osteopathic MedicineGraduated 2019
Enumeration DateApril 8, 2019
Last NPPES UpdateAugust 25, 20252 updates tracked since enumeration
NPPES CertifiedAugust 25, 2025
✔ NPI 1114480217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License✔ Licensed in AR · E-15736
Definition

A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.

Also ListedPediatricsTaxonomy 208000000X · License E-15736 (AR)
1 CHILDRENS WAY # 512-19A, Little Rock, AR 72202
Open in Google Maps ↗

Secondary Practice Location 1

Location 14301 W Markham St # 783Little Rock, AR 72205-7101 · Phone (501) 686-8000 · Fax (501) 526-5148

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Timothy Edward Nissen Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4284969734
PECOS Enrollment IDI20250908002024
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GARY LACROIX MD
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1100
KAITLYN BURRICHTER FULFORD
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1874
PAIGE VICTORIA STREBECK MD
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1874
RACHEL MAYO MD
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1874
SKYE TAYLOR HECKMAN MD
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1874
DR. SONIA MARIE STASYSZYN MD
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1874
MAKENZIE LAINE NIVEN MD
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1874
DR. ALEXIS MARIE DERRIGO MD
Student in an Organized Health Care Education/Training Program
1 CHILDRENS WAY # 512-19A
LITTLE ROCK, AR 72202
Pulaski County (501) 364-1874

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Nissen's NPI number?

The NPI number for Timothy Nissen is 1114480217. It was assigned to this individual provider in the NPPES registry on April 8, 2019.

Where is Timothy Nissen located?

Timothy Nissen practices at 1 Childrens Way # 512-19a, Little Rock, AR 72202. The listed phone number is (501) 364-1874.

What is Timothy Nissen's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Is Timothy Nissen enrolled in Medicare?

Yes. Timothy Nissen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Timothy Nissen accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Timothy Nissen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Timothy Nissen was last updated on August 25, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.