Individual provider Active NPI

Timothy M Foster, D.C.

  • Chiropractor
  • Ballwin, MO
National Provider Identifier
1063552321
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6458 Issued in MO
Practice address
14748 Manchester Rd
Suite a
Ballwin, MO 63011-3706
Phone
(636) 391-3300
Fax
(636) 391-0047
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6458 MO Primary

Addresses

Primary practice location

14748 Manchester Rd
Suite a
Ballwin, MO 63011-3706

Mailing address

14748 Manchester Rd
Suite a
Ballwin, MO 63011
Phone (636) 391-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120213000399 MO Practitioner - Chiropractic 0749447159 Practice locations: Ballwin, MO

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14748 A Manchester Rd
Ballwin, MO 63011-3706
Phone (636) 391-3300

14748 Manchester Rd
Suite a
Ballwin, MO 63011-3706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6458MOMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063552321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14748 MANCHESTER RD",
            "address_2": "SUITE A",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "63011",
            "telephone_number": "636-391-3300",
            "fax_number": "636-391-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14748 MANCHESTER RD",
            "address_2": "SUITE A",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630113706",
            "telephone_number": "636-391-3300",
            "fax_number": "636-391-0047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "TIMOTHY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "6458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.