Active NPI
Timothy Williams, DC
- Chiropractor
- Portland, OR
National Provider Identifier
1124617279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 6126
- Practice address
- 1818 NE MLK Blvd Ste C
Portland, OR 97212-3976 - Phone
- (503) 206-8988
- NPI assigned
- Jan 13, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6126 | OR | Primary |
Addresses
Primary practice location
1818 NE MLK Blvd Ste C
Portland, OR 97212-3976
Mailing address
16977 NE Halsey St # D117
Portland, OR 97230-6183
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6126 | OR | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Massage Comfort and Spa Inc | 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": "1610496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610496000000",
"number": "1124617279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16977 NE HALSEY ST # D117",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972306183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1818 NE MLK BLVD STE C",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972123976",
"telephone_number": "503-206-8988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "TIMOTHY",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-13",
"last_updated": "2021-01-13",
"certification_date": "2021-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "6126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.