Individual provider Active NPI

Greg S Tomalin, D.C.

  • Chiropractor
  • Broomfield, CO
National Provider Identifier
1336160449
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4983 Issued in CO
Practice address
13606 Xavier LN
Unit D
Broomfield, CO 80023-3604
Phone
(720) 887-0624
Fax
(720) 887-0632
NPI assigned
Jul 22, 2006
Last updated
Oct 1, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4983 CO Primary

Addresses

Primary practice location

13606 Xavier LN
Unit D
Broomfield, CO 80023-3604

Mailing address

13606 Xavier LN
Unit D
Broomfield, CO 80023-3604
Phone (720) 887-0624

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060206000147 CO Practitioner - Chiropractic 3971517418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5153 W 120TH Ave
Broomfield, CO 80020-5608
Phone (720) 887-0624

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4983COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Wellness Chiropractic Chiropractor CurrentSince Nov 7, 2005 Accepting new patients

Locations

13606 Xavier Ln
Ste D
Broomfield, CO 80023
Phone (720) 708-2345

5153 W 120th Ave
Broomfield, CO 80020
Phone (303) 404-0950

1020 Ken Pratt Blvd
Unit G
Longmont, CO 80501
Phone (303) 722-8311

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1336160449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13606 XAVIER LN",
            "address_2": "UNIT D",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800233604",
            "telephone_number": "720-887-0624",
            "fax_number": "720-887-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13606 XAVIER LN",
            "address_2": "UNIT D",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800233604",
            "telephone_number": "720-887-0624",
            "fax_number": "720-887-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMALIN",
        "first_name": "GREG",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "4983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.