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MR. TIMOTHY ROY ANKENMAN RD
NPI 1235069964
Dietitian, Registered in Meridian, ID

Active since May 22, 2026
5155 S HILLSDALE AVE, MERIDIAN, ID 83642(208) 706-9710(208) 706-9728 Get Directions Write a Review

NPPES record last updated: June 23, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mr. Timothy Roy Ankenman Rd NPPES

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

MR. TIMOTHY ROY ANKENMAN RD (NPI 1235069964) is an individual dietitian, registered in Meridian, Idaho, licensed in Idaho (D-1301) and active in the NPI registry since May 2026. He is a graduate of University Of Mississippi School Of Medicine (2020).

NPPES Registry Identity

NPI1235069964
Entity TypeIndividualMale
Primary Taxonomy133V00000X
Provider Legal NameMR. TIMOTHY ROY ANKENMANCredential: RD
Location Address5155 S HILLSDALE AVEMeridian, ID 83642-7587
Mailing Address190 E Bannock StBoise, ID 83712-6241
Phone(208) 706-9710
Fax(208) 706-9728
Sole ProprietorNo
Medical School CMSUniversity Of Mississippi School Of MedicineGraduated 2020
Enumeration DateMay 22, 2026
Last NPPES UpdateJune 23, 2026
NPPES CertifiedJune 23, 2026
✔ NPI 1235069964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
Licenses✔ Licensed in ID · D-1301✔ Licensed · 86066149
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
Also ListedDietitian, Registered · Nutrition, Sports DieteticsTaxonomy 133VN1501X · License 86066149
5155 S HILLSDALE AVE, Meridian, ID 83642
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Other Names 1

Other Name (5)Mr. Tim Roy Ankenman Rd

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Select Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Timothy Roy Ankenman Rd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6002370913
PECOS Enrollment IDI20260713000317

Medicare Billing Reassignment

Medicare enrollment records show Timothy Ankenman reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St Lukes Clinic-Treasure Valley LLC
8.6 mi
Family Medicine
190 E BANNOCK ST
Boise, ID 83712
  • Reassigned Medicare billing, Idaho enrollment
  • 1,312 clinicians in this Medicare group
NPI 1326336058 (208) 381-2222

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 5

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

MS. LESA MARIE BREDING LCSW
Social Worker (Clinical)
5155 S HILLSDALE AVE
MERIDIAN, ID 83642
Ada County (208) 706-9710
ASHLI FISHMAN FRANK RN, NBHWC
Health and Wellness Coach
5155 S HILLSDALE AVE
MERIDIAN, ID 83642
Ada County (208) 706-9710
JANET A PACE LCSW
Social Worker (Clinical)
5155 S HILLSDALE AVE
MERIDIAN, ID 83642
Ada County (208) 706-9710
ANGELINA PATTERSON REGISTERED NURSE
Health and Wellness Coach
5155 S HILLSDALE AVE
MERIDIAN, ID 83642
Ada County (208) 706-9710
TIA NOWACKI ATC, NBC-HWC
Health and Wellness Coach
5155 S HILLSDALE AVE
MERIDIAN, ID 83642
Ada County (208) 706-9710

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 Ankenman's NPI number?

The NPI number for Timothy Ankenman is 1235069964. It was assigned to this individual provider in the NPPES registry on May 22, 2026. The provider is also known as Mr. Tim Roy Ankenman Rd.

Where is Timothy Ankenman located?

Timothy Ankenman practices at 5155 S Hillsdale Ave, Meridian, ID 83642. The listed phone number is (208) 706-9710.

What is Timothy Ankenman's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Timothy Ankenman enrolled in Medicare?

Yes. Timothy Ankenman is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Timothy Ankenman's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Timothy Ankenman reassigns Medicare benefits to St Lukes Clinic-Treasure Valley LLC (Boise, ID). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Timothy Ankenman's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Timothy Ankenman accept?

Health plans from PacificSource Health Plans and Select Health list Timothy Ankenman 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 Ankenman was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.