Individual provider Active NPI

Timothy Arnold Cummins, D.C.

  • Chiropractor
  • Bethlehem, GA
National Provider Identifier
1417017757
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5331 Issued in CO
Practice address
916 Loganville Hwy Ste 1110
Bethlehem, GA 30620-2150
Phone
(678) 963-0127
NPI assigned
Dec 9, 2006
Last updated
Dec 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR010600 GA
Chiropractor 111N00000X 5331 CO Primary

Addresses

Primary practice location

916 Loganville Hwy Ste 1110
Bethlehem, GA 30620-2150

Mailing address

1815 Silver Oak Dr
Bethlehem, GA 30620-4532
Phone (303) 913-4904

Other practice location 1

15236 E Hampden Ave
Aurora, CO 80014-3908
Phone (720) 747-5333

Other identifiers 1

IdentifierTypeStateIssuer
204004008OtherCOTAX ID #

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
CHIR010600GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Iwc Georgia, Inc Chiropractor CurrentSince Dec 26, 2021 Accepting new patients
Iwcga Monroe LLC Chiropractor Current Accepting new patients
The Vitality Group LLC Chiropractor PastSince Aug 14, 2022 Accepting new patients

Locations

916 Loganville Hwy
Ste 1110
Bethlehem, GA 30620
Phone (303) 913-4904

Organizations & group practices 3

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": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1417017757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 SILVER OAK DR",
            "city": "BETHLEHEM",
            "state": "GA",
            "postal_code": "306204532",
            "telephone_number": "303-913-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 LOGANVILLE HWY STE 1110",
            "city": "BETHLEHEM",
            "state": "GA",
            "postal_code": "306202150",
            "telephone_number": "678-963-0127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15236 E Hampden Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800143908",
            "country_code": "US",
            "telephone_number": "720-747-5333",
            "fax_number": "303-671-7247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUMMINS",
        "first_name": "TIMOTHY",
        "middle_name": "ARNOLD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-09",
        "last_updated": "2021-12-23",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010600",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "204004008",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethlehem, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.