Individual provider Active NPI

Timothy M Wasmund, DC

  • Chiropractor
  • Rochester, MI
National Provider Identifier
1194865626
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009294 Issued in MI
Practice address
1420 N Rochester Rd
Rochester, MI 48307
Phone
(248) 650-6100
Fax
(248) 650-3751
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X TW009294 MI
Chiropractor 111N00000X 2301009294 MI Primary

Addresses

Primary practice location

1420 N Rochester Rd
Rochester, MI 48307

Mailing address

1420 N Rochester Rd
Rochester, MI 48307-1188
Phone (248) 650-6100

Other practice location 1

44200 Woodward Ave.
Ste. 112
Pontiac, MI 48341
Phone (877) 784-3667

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070626000175 MI Practitioner - Chiropractic 4587763933 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Purdy Chiropractic of Rochester PLLCGroup PAC ID 2860591393, 3 clinicians

Practice addresses (Care Compare)

427 6TH St
Rochester, MI 48307-1401
Phone (248) 650-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TW009294MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
University Neurosurgical Associates PC CurrentSince May 1, 2012 Accepting new patients
Purdy Chiropractic of Rochester PLLC Chiropractor CurrentSince Sep 1, 2020 Accepting new patients
University Neurosurgical Associates, PC CurrentSince May 1, 2012 Accepting new patients

Locations

2319 Momentum Pl
Chicago, IL 60689

32500 23 Mile Rd
Chesterfield, MI 48047
Phone (586) 725-3100

43475 Dalcoma Dr
Ste 150
Clinton Twp, MI 48038
Phone (248) 784-3667

44200 Woodward Ave
Ste 112
Pontiac, MI 48341
Phone (248) 384-8100

427 6th St
Rochester, MI 48307
Phone (248) 601-6100

1420 N Rochester Rd
Rochester Hls, MI 48307
Phone (248) 495-1764

29275 Northwestern Hwy
Ste 100
Southfield, MI 48034
Phone (248) 351-6300

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1194865626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 N ROCHESTER RD",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071188",
            "telephone_number": "248-650-6100",
            "fax_number": "248-650-3751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 N ROCHESTER RD",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "48307",
            "telephone_number": "248-650-6100",
            "fax_number": "248-650-3751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44200 Woodward Ave.",
            "address_2": "Ste. 112",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "48341",
            "country_code": "US",
            "telephone_number": "877-784-3667",
            "fax_number": "248-409-3290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASMUND",
        "first_name": "TIMOTHY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "TW009294",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; 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.