Individual provider Active NPI

Timothy Ryan Purcell, D.C.

  • Chiropractor
  • Edinboro, PA
National Provider Identifier
1285634147
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC008936 Issued in PA
Practice address
111 Walker Dr
Edinboro, PA 16412-2237
Phone
(814) 734-3991
Fax
(814) 734-0812
NPI assigned
Jul 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC008936 PA Primary

Addresses

Primary practice location

111 Walker Dr
Edinboro, PA 16412-2237

Mailing address

111 Walker Dr
Edinboro, PA 16412-2237
Phone (814) 734-3991

Other identifiers 2

IdentifierTypeStateIssuer
0019386290002MedicaidPA
1445674OtherPAHIGHMARK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041220000790 PA Practitioner - Chiropractic 0547228736 Reassigns benefits to 1 organization
Practice locations: Waterford, PA; Knox, PA; Erie, PA; Spartansburg, PA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

108 Rossman Ave
Knox, PA 16232-1844
Phone (814) 797-2863

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Chiropractic of Knox, Inc. Chiropractor CurrentSince Jan 19, 2017 Accepting new patients
Bespoke Chiropractic LLC Chiropractor PastSince Jul 6, 2021 Accepting new patients
Pleasantview Chiropractic, LLC Chiropractor Past Accepting new patients

Locations

108 Rossman Ave
Knox, PA 16232
Phone (814) 797-2863

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1285634147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WALKER DR",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164122237",
            "telephone_number": "814-734-3991",
            "fax_number": "814-734-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WALKER DR",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164122237",
            "telephone_number": "814-734-3991",
            "fax_number": "814-734-0812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURCELL",
        "first_name": "TIMOTHY",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC008936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019386290002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "1445674",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinboro, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.