Timothy Jude Dieckman, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38NJMC0047700 Issued in NJ

Practice address

631 Jamaica Blvd
Suite #1
Toms River, NJ 08757-4000

Phone

(732) 341-6555

Fax

(732) 557-6369

NPI assigned

Jan 18, 2007

Last updated

Aug 7, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1083766935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "PINE BEACH",
            "state": "NJ",
            "postal_code": "08741",
            "telephone_number": "732-341-6555",
            "fax_number": "732-557-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 JAMAICA BLVD",
            "address_2": "SUITE #1",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087574000",
            "telephone_number": "732-341-6555",
            "fax_number": "732-557-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIECKMAN",
        "first_name": "TIMOTHY",
        "middle_name": "JUDE",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38NJMC0047700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kadidiatou Diawara
• Daniel Dicesare, DMD
• Frank Patrick Dichiara, D.O.
• David Brian Dickerson, M.D.
• William J Didie, MD
• Allison M Dierking, LSW
• Geraldine Dierking, LCSW
• Thomas Dietze, COTA/L
• Jaclyn E Digesere, LCSW, MSW
• William R Dilorenzo, D.O.

• Chiropractor in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; 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.