Individual provider Active NPI

Timothy Leonard Probe, DC

  • Chiropractor
  • Woodbury Heights, NJ
National Provider Identifier
1275516247
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00269500 Issued in NJ
Practice address
740 Mantua Pike
Woodbury Heights, NJ 08097-1149
Phone
(856) 845-0360
Fax
(856) 845-1881
NPI assigned
Nov 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 38MC00269500 NJ Primary

Addresses

Primary practice location

740 Mantua Pike
Woodbury Heights, NJ 08097-1149

Mailing address

5 Springhill Rd
Mantua, NJ 08051-1601
Phone (856) 853-1114

Other identifiers 1

IdentifierTypeStateIssuer
1758900MedicaidNJ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111107000158 NJ Practitioner - Chiropractic 7517049828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

740 Mantua Pike
Woodbury Heights, NJ 08097-1149
Phone (856) 845-0360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Physicians Network, P.C. Chiropractor CurrentSince Jan 1, 1987 Accepting new patients
Premium Healthcare Holdings, LLLP Past Accepting new patients

Locations

740 Mantua Pike
Woodbury Hts, NJ 08097
Phone (856) 845-0360

Organizations & group practices 2

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": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1275516247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SPRINGHILL RD",
            "city": "MANTUA",
            "state": "NJ",
            "postal_code": "080511601",
            "telephone_number": "856-853-1114",
            "fax_number": "856-845-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 MANTUA PIKE",
            "city": "WOODBURY HEIGHTS",
            "state": "NJ",
            "postal_code": "080971149",
            "telephone_number": "856-845-0360",
            "fax_number": "856-845-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROBE",
        "first_name": "TIMOTHY",
        "middle_name": "LEONARD",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00269500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1758900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury Heights, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.