Individual provider Active NPI

Thomas J Newbauer, D.C.

  • Chiropractor
  • Sullivan, IN
National Provider Identifier
1013903186
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001634A Issued in IN
Practice address
777 N Wolfenberger St
Sullivan, IN 47882-7242
Phone
(812) 230-9055
NPI assigned
Sep 23, 2005
Last updated
Jun 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001634A IN Primary
Chiropractor 111N00000X 08001643A IN

Addresses

Primary practice location

777 N Wolfenberger St
Sullivan, IN 47882-7242

Mailing address

777 N Wolfenberger St
Sullivan, IN 47882-7242
Phone (812) 230-9055

Other identifiers 1

IdentifierTypeStateIssuer
000000340406OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08001643AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnessfirst of Sullivan Chiropractor CurrentSince Jan 14, 2017 Accepting new patients
Chiropractic Resource Center Chiropractor Past Accepting new patients
Dupont Chiropractic Resource Center Inc. Chiropractor PastSince Jul 15, 2011 Accepting new patients
Spinal Healthcare and Physical Medicine LLC Single Specialty PastSince Oct 6, 2016 Accepting new patients

Locations

222 W Beech St
Sullivan, IN 47882
Phone (812) 268-3400

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1013903186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 N WOLFENBERGER ST",
            "city": "SULLIVAN",
            "state": "IN",
            "postal_code": "478827242",
            "telephone_number": "812-230-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 N WOLFENBERGER ST",
            "city": "SULLIVAN",
            "state": "IN",
            "postal_code": "478827242",
            "telephone_number": "812-230-9055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBAUER",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001634A",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001643A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000340406",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sullivan, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.