Basic Information
| Provider Information | |||||||||
| NPI: | 1114920105 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OCHS | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | SUTTON | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CRNA, APN | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 965 | ||||||||
| Address2: | |||||||||
| City: | HARRIMAN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 377480965 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8655900933 | ||||||||
| FaxNumber: | 8655900933 | ||||||||
| Practice Location | |||||||||
| Address1: | 1236 KNOXVILLE HWY | ||||||||
| Address2: | |||||||||
| City: | WARTBURG | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378874200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4233466556 | ||||||||
| FaxNumber: | 4233467541 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2005 | ||||||||
| LastUpdateDate: | 03/11/2008 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 130201 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | 1326382 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 3154746 | 01 | TN | BLUE SHIELD | OTHER | 3630889 | 05 | TN | MEDICAID | 430059007 | 01 | TN | RAILROAD MEDICARE | OTHER |