Individual provider Active NPI

David Lee Timmerman, D.C.

  • Chiropractor
  • Norfolk, NE
National Provider Identifier
1376564161
Registry record updated Mar 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1212 Issued in NE
Practice address
509 N 13TH St
Norfolk, NE 68701-3715
Phone
(402) 371-9000
NPI assigned
Jul 21, 2006
Last updated
Mar 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1212 NE Primary

Addresses

Primary practice location

509 N 13TH St
Norfolk, NE 68701-3715

Mailing address

509 N 13TH St
Norfolk, NE 68701-3715
Phone (402) 371-9000

Other identifiers 2

IdentifierTypeStateIssuer
10024953100MedicaidNE
1212OtherNELICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080216000043 NE Practitioner - Chiropractic 5395828131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Chiropractic and Wellness PCGroup PAC ID 4789760778, 2 clinicians

Practice addresses (Care Compare)

509 N 13TH St
Norfolk, NE 68701-3715
Phone (402) 371-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1212NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Chiropractic and Wellness, P.C. Chiropractor CurrentSince Jan 14, 2008 Accepting new patients

Locations

509 N 13th St
Norfolk, NE 68701
Phone (402) 371-9000

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, 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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520553600000",
    "number": "1376564161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 N 13TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687013715",
            "telephone_number": "402-371-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N 13TH ST",
            "city": "NORFOLK",
            "state": "NE",
            "postal_code": "687013715",
            "telephone_number": "402-371-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIMMERMAN",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2018-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10024953100",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "1212",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2018; 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.