Timothy Icenogle, MD
NPI 1285683029 · Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Ogden, UT
Provider details
- NPI number
- 1285683029
- Entity type
- Individual
- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- MD00026659 (WA)
Specialties & taxonomies
- Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianPrimary208G00000XLicense 126770044-1205 (UT)
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (2)
- 100 Hillcrest Medical BlvdWaco, TX 76712-8897Phone: (254) 202-2000Fax: (254) 202-5849
- 3415 W Horizon AveSpokane, WA 99208-8493Phone: (509) 220-1900
Registry dates
- Enumerated
- 2006-05-09
- Last updated
- 2022-12-13
- Certified
- 2022-12-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.