Active NPI
Timothy W Bogren, D.C.
- Chiropractor
- Milton, WV
National Provider Identifier
1245309004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 608
- Practice address
- 332 E Main St
Milton, WV 25541-1508 - Phone
- (304) 743-1261
- Fax
- (304) 743-1899
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 608 | WV | Primary |
Addresses
Primary practice location
332 E Main St
Milton, WV 25541-1508
Mailing address
332 E Main St
Milton, WV 25541-1508
Phone (304) 743-1261
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001711177 | Other | WV | MT. ST. BCBS |
| 0131934000 | Medicaid | WV |
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 |
|---|---|---|---|
| 608 | WV | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219795200000",
"number": "1245309004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "332 E MAIN ST",
"city": "MILTON",
"state": "WV",
"postal_code": "255411508",
"telephone_number": "304-743-1261",
"fax_number": "304-743-1899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "332 E MAIN ST",
"city": "MILTON",
"state": "WV",
"postal_code": "255411508",
"telephone_number": "304-743-1261",
"fax_number": "304-743-1899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOGREN",
"first_name": "TIMOTHY",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2008-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "WV",
"license": "608",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MT. ST. BCBS",
"identifier": "001711177",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0131934000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.