1. Home
  2. Directory
  3. Tennessee
  4. Cookeville
  5. Physician Assistant
  6. NPI Profile

MR. TIMOTHY E VIVIAN PA
NPI 1679568968
Physician Assistant - Medical in Cookeville, TN

Active since September 13, 2005PECOS Enrolled
675 SOUTH JEFFERSON AVE, COOKEVILLE, TN 38501(931) 520-0148(931) 520-0152 Get Directions Write a Review

NPPES record last updated: June 20, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Timothy E Vivian Pa NPPES

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

MR. TIMOTHY E VIVIAN PA (NPI 1679568968) is an individual medical provider in Cookeville, Tennessee, licensed in Tennessee (P0770) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679568968
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. TIMOTHY E VIVIANCredential: PA
Location Address675 SOUTH JEFFERSON AVECookeville, TN 38501-0949
Mailing Address675 South Jefferson AveCookeville, TN 38501-0949 · (931) 520-0148 · Fax (931) 520-0152
Phone(931) 520-0148
Fax(931) 520-0152
Sole ProprietorYes
Enumeration DateSeptember 13, 2005
Last NPPES UpdateJune 20, 2012
✔ NPI 1679568968 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in TN · P0770
675 SOUTH JEFFERSON AVE, Cookeville, TN 38501
Open in Google Maps ↗

Other Identifiers 2

Medicare UPINP36605TN
Medicare ID-Type Unspecified3669495TN

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Timothy E Vivian Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Referred Medical Equipment & Supplies CMS DME claims 8

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
7 suppliers26 claims52 services$5.77 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
3 suppliers13 claims13 services$74.73 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
3 suppliers14 claims80 services$3.21 avg. paid by Medicare
Humidifier, heated, used with positive airway pressure device E0562
DME-Other DME · category DE001N
1 supplier27 claims27 services$18.12 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
3 suppliers16 claims16 services$7.72 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers30 claims30 services$55.44 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Vivian's NPI number?

The NPI number for Timothy Vivian is 1679568968. It was assigned to this individual provider in the NPPES registry on September 13, 2005.

Where is Timothy Vivian located?

Timothy Vivian practices at 675 South Jefferson Ave, Cookeville, TN 38501. The listed phone number is (931) 520-0148.

What is Timothy Vivian's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Timothy Vivian enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Timothy Vivian was last updated on June 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years 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.