Individual provider Active NPI

Tim Dennis Treanor, DC

  • Chiropractor
  • Rocky Mount, NC
National Provider Identifier
1154362952
Registry record updated Apr 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
NC2457 Issued in NC
Practice address
4161 Capital Drive
Rocky Mount, NC 27804-3128
Phone
(252) 903-3103
Fax
(252) 210-3489
NPI assigned
Jun 10, 2006
Last updated
Apr 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NC2457 NC Primary

Addresses

Primary practice location

4161 Capital Drive
Rocky Mount, NC 27804-3128

Mailing address

4161 Capital Drive
Rocky Mount, NC 27804-3128
Phone (252) 903-3103

Other identifiers 4

IdentifierTypeStateIssuer
1154362952MedicaidNC
0828YOtherNCBCBS
1154362952OtherNCCNC/MC/MD
890828YMedicaidNC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
NC2457NCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Medical CurrentSince May 31, 2023 Accepting new patients
Edgecombe Chiropractic Inc Chiropractor PastSince Feb 1, 2005 Accepting new patients
Hammer Chiropractic Inc Chiropractor PastSince May 1, 1997 Accepting new patients

Locations

4161 Capital Dr
Rocky Mount, NC 27804
Phone (252) 210-3490

Organizations & group practices 3

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1154362952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4161 CAPITAL DRIVE",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043128",
            "telephone_number": "252-903-3103",
            "fax_number": "252-210-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4161 CAPITAL DRIVE",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278043128",
            "telephone_number": "252-903-3103",
            "fax_number": "252-210-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREANOR",
        "first_name": "TIM",
        "middle_name": "DENNIS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "NC2457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154362952",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0828Y",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNC/MC/MD",
            "identifier": "1154362952",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890828Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.