Individual provider Active NPI

Timothy Ryan Warner, D.C.

  • Chiropractor
  • Point Pleasant Boro, NJ
National Provider Identifier
1245503283
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00697300 Issued in NJ
Practice address
2124 Bridge Ave
Point Pleasant Boro, NJ 08742-4914
Phone
(732) 892-5775
Fax
(732) 892-5727
NPI assigned
Feb 22, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00697300 NJ Primary

Addresses

Primary practice location

2124 Bridge Ave
Point Pleasant Boro, NJ 08742-4914

Mailing address

2124 Bridge Ave
Point Pleasant Boro, NJ 08742-4914
Phone (732) 892-5775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120515000080 NJ Practitioner - Chiropractic 5294998001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Warner Family and Sports Chiropractic LLCGroup PAC ID 2769757764, 2 clinicians

Practice addresses (Care Compare)

2124 Bridge Ave
Point Pleasant Boro, NJ 08742-4914
Phone (732) 892-5775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Warner Family and Sports Chiropractic LLC Chiropractor CurrentSince Jul 30, 2018 Accepting new patients

Locations

2124 Bridge Ave
Point Pleasant Boro, NJ 08742
Phone (732) 892-5775

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": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329868800000",
    "number": "1245503283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 BRIDGE AVE",
            "city": "POINT PLEASANT BORO",
            "state": "NJ",
            "postal_code": "087424914",
            "telephone_number": "732-892-5775",
            "fax_number": "732-892-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 BRIDGE AVE",
            "city": "POINT PLEASANT BORO",
            "state": "NJ",
            "postal_code": "087424914",
            "telephone_number": "732-892-5775",
            "fax_number": "732-892-5727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER",
        "first_name": "TIMOTHY",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00697300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Point Pleasant Boro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.