Organization Active NPI

Tieman Chiropractic and Rehabilitation LLC

  • Chiropractor
  • Boonville, IN
National Provider Identifier
1316146558
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001912A Issued in IN
Legal business name
TIEMAN CHIROPRACTIC AND REHABILITATION LLC
Practice address
202 S 4TH St
Boonville, IN 47601-1806
Phone
(812) 897-4616
NPI assigned
Jul 17, 2007
Last updated
Oct 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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

Authorized official

Name
Dr. Dennis P Tieman, D.C.NPI 1992848113
Title
Chiropractor
Phone
(812) 897-4616

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001912A IN Primary

Addresses

Primary practice location

202 S 4TH St
Boonville, IN 47601-1806

Mailing address

202 S 4TH St
Boonville, IN 47601-1806
Phone (812) 897-4616

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101014000433 IN Part B Supplier - Clinic/Group Practice 5193917748 Receives reassigned benefits from 1 practitioner
Practice locations: Boonville, IN

National Provider Directory

National Provider Directory

Locations

202 S 4th St
Boonville, IN 47601
Phone (812) 660-2270

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287014400000",
    "number": "1316146558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S 4TH ST",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "476011806",
            "telephone_number": "812-897-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 S 4TH ST",
            "city": "BOONVILLE",
            "state": "IN",
            "postal_code": "476011806",
            "telephone_number": "812-897-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIEMAN CHIROPRACTIC AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2010-10-14",
        "status": "A",
        "authorized_official_last_name": "TIEMAN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "812-897-4616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001912A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.