Individual provider Active NPI

Walter E Tumlinson, D.C.

  • Chiropractor
  • Jackson, MI
National Provider Identifier
1417914425
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301005332 Issued in MI
Practice address
4821 Lansing Ave
Jackson, MI 49201-8241
Phone
(517) 783-2833
Fax
(517) 783-2834
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301005332 MI Primary

Addresses

Primary practice location

4821 Lansing Ave
Jackson, MI 49201-8241

Mailing address

4821 Lansing Ave
Jackson, MI 49201-8241
Phone (517) 783-2833

Other identifiers 3

IdentifierTypeStateIssuer
950C85006OtherMIBCBS
2673690MedicaidMI
350025358OtherMIPALMETTO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080721000563 MI Practitioner - Chiropractic 6204909633 Practice locations: Jackson, MI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4821 Lansing Ave
Jackson, MI 49201-8241
Phone (517) 783-2833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1417914425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4821 LANSING AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018241",
            "telephone_number": "517-783-2833",
            "fax_number": "517-783-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4821 LANSING AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492018241",
            "telephone_number": "517-783-2833",
            "fax_number": "517-783-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUMLINSON",
        "first_name": "WALTER",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "950C85006",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2673690",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "350025358",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; 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.