Individual provider Active NPI

Thomas C. Chew, D.C.

  • Chiropractor
  • Oakland, CA
National Provider Identifier
1376693291
Registry record updated Sep 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
17058 Issued in CA
Practice address
3540 Grand Ave
Oakland, CA 94610-2010
Phone
(510) 628-8460
Fax
(510) 268-8591
NPI assigned
Jan 11, 2007
Last updated
Sep 2, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 17058 CA Primary

Addresses

Primary practice location

3540 Grand Ave
Oakland, CA 94610-2010

Mailing address

15550 Rockfield Blvd
B220
Irvine, CA 92618-2720
Phone (949) 598-9999

Other identifiers 1

IdentifierTypeStateIssuer
DC17058OtherCACHIROPRACTIC LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070223000382 CA Practitioner - Chiropractic 2668574575 Practice locations: Concord, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Back Doctors of Concord Chiropractor Past Accepting new patients

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283385600000",
    "number": "1376693291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15550 ROCKFIELD BLVD",
            "address_2": "B220",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182720",
            "telephone_number": "949-598-9999",
            "fax_number": "949-598-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 GRAND AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946102010",
            "telephone_number": "510-628-8460",
            "fax_number": "510-268-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEW",
        "first_name": "THOMAS",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2010-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "17058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "DC17058",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.