Active NPI
Timothy Flynn, DC
- Chiropractor
- Crestview, FL
National Provider Identifier
1235397886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH7375
- Practice address
- 102 N Main St
Crestview, FL 32536-3546 - Phone
- (850) 682-9697
- Fax
- (850) 683-9670
- NPI assigned
- May 30, 2008
- 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 | CH7375 | FL | Primary |
Addresses
Primary practice location
102 N Main St
Crestview, FL 32536-3546
Mailing address
102 N Main St
Crestview, FL 32536-3546
Phone (850) 682-9697
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55681 | Other | FL | BCBS OF FL |
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 |
|---|---|---|---|
| CH7375 | FL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212105600000",
"number": "1235397886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 N MAIN ST",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325363546",
"telephone_number": "850-682-9697",
"fax_number": "850-683-9670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 N MAIN ST",
"city": "CRESTVIEW",
"state": "FL",
"postal_code": "325363546",
"telephone_number": "850-682-9697",
"fax_number": "850-683-9670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLYNN",
"first_name": "TIMOTHY",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-30",
"last_updated": "2008-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH7375",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF FL",
"identifier": "55681",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crestview, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.