Individual provider Active NPI

Timothy A Christopherson, D.C.

  • Chiropractor
  • Colorado Springs, CO
National Provider Identifier
1083896179
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6122 Issued in CO
Practice address
1410 S 21St St
Colorado Springs, CO 80904-4204
Phone
(719) 632-4225
NPI assigned
Nov 29, 2007
Last updated
Dec 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 60187362 WA
Chiropractor 111N00000X 2514 TN
Chiropractor 111N00000X 6122 CO Primary

Addresses

Primary practice location

1410 S 21St St
Colorado Springs, CO 80904-4204

Mailing address

1410 S 21St St
Colorado Springs, CO 80904-4204
Phone (719) 632-4225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090129000597 CO Practitioner - Chiropractic 6406910892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1410 S 21St St
Colorado Springs, CO 80904-4204
Phone (719) 632-4225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6122COMDAddiction (Substance Use Disorder) Counselor
CH 60187362WAMDChiropractor
2514TNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Walford DC, PC Chiropractor CurrentSince Aug 1, 2024 Accepting new patients

Locations

1410 S 21st St
Colorado Springs, CO 80904
Phone (719) 632-4225

Organizations & group practices 2

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": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1083896179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 S 21ST ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809044204",
            "telephone_number": "719-632-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 S 21ST ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809044204",
            "telephone_number": "719-632-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHERSON",
        "first_name": "TIMOTHY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-29",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH 60187362",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2514",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "6122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.