Individual provider Active NPI

Timothy John Weimer, DC

  • Chiropractor
  • Modesto, CA
National Provider Identifier
1124297882
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-30849 Issued in CA
Practice address
2813 Coffee Rd BLDG F
Modesto, CA 95355-1755
Phone
(209) 549-9987
NPI assigned
Feb 27, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-30849 CA Primary

Addresses

Primary practice location

2813 Coffee Rd BLDG F
Modesto, CA 95355-1755

Mailing address

2813 Coffee Rd BLDG F
Modesto, CA 95355-1755
Phone (209) 549-9987

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080702000230 CA Practitioner - Chiropractic 0749352078 Practice locations: Modesto, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2813 Coffee Rd BLDG F
Modesto, CA 95355-1755

2813 Coffee Rd F
Modesto, CA 95355-1755
Phone (209) 549-9987

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-30849CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Weimer Chiropractic Professional Corporation Chiropractor Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1124297882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2813 COFFEE RD BLDG F",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551755",
            "telephone_number": "209-549-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2813 COFFEE RD BLDG F",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551755",
            "telephone_number": "209-549-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIMER",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-27",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC-30849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.