Individual provider Active NPI

Thomas Owen Ayres, D.C.

  • Chiropractor
  • Saint Paul, MN
National Provider Identifier
1376725036
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4385 Issued in MN
Practice address
3495 Willow Lake Blvd
Suite 300
Saint Paul, MN 55110-5138
Phone
(651) 766-3855
Fax
(651) 766-7884
NPI assigned
Dec 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 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 4385 MN Primary

Addresses

Primary practice location

3495 Willow Lake Blvd
Suite 300
Saint Paul, MN 55110-5138

Mailing address

3495 Willow Lake Blvd
Suite 300
Saint Paul, MN 55110-5138
Phone (651) 766-3855

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4385MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Chiropractic Health Center 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1376725036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 WILLOW LAKE BLVD",
            "address_2": "SUITE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551105138",
            "telephone_number": "651-766-3855",
            "fax_number": "651-766-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 WILLOW LAKE BLVD",
            "address_2": "SUITE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551105138",
            "telephone_number": "651-766-3855",
            "fax_number": "651-766-7884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYRES",
        "first_name": "THOMAS",
        "middle_name": "OWEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.