Provider Demographics
NPI:1023076072
Name:BATEMAN, TIMOTHY M (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:M
Last Name:BATEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 WORNALL RD
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-5939
Mailing Address - Country:US
Mailing Address - Phone:816-931-1883
Mailing Address - Fax:816-756-3645
Practice Address - Street 1:4330 WORNALL RD
Practice Address - Street 2:SUITE 2000
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5939
Practice Address - Country:US
Practice Address - Phone:816-931-1883
Practice Address - Fax:816-756-3645
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3H36207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100135630EOtherMEDICAID-CUSHING
KS100135630AMedicaid
MO202555504Medicaid
KSP00842591OtherRAILROAD MEDICARE
KY100135630HMedicaid
KSKA1021047OtherMEDICARE - CUSHING
MOP00842654OtherRAILROAD MEDICARE
KS100135630GMedicaid
KS100135630AMedicaid
KSKA2004004Medicare PIN
KSP00842591OtherRAILROAD MEDICARE
KSKA1021047OtherMEDICARE - CUSHING
KY100135630HMedicaid