Timothy Thomas Bertsch, DC
Individual provider Active NPI Internist Chiropractor · Champlin, MN
NPI 1437154671 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1437154671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internist Chiropractor 111NI0900X
- License
- 2076 (MN)
- Practice address
- 12217 Champlin Dr
Champlin, MN 55316-1930 - Phone
- (763) 323-1492
- NPI assigned
- Jun 15, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101018000176 | MN | Practitioner - Chiropractic | 0143413674 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Team Health Care Clinic PC | Internist | Current |
Accepting new patients |
Locations
12217 Champlin Dr
Champlin, MN 55316
Phone (763) 323-1492
Interoperability endpoints
- timothybertsch@thccp-mn.direct.office.nextgen.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internist Chiropractor | 111NI0900X | 2076 | MN | Yes |
Addresses
Primary practice location
12217 Champlin Dr
Champlin, MN 55316-1930
Mailing address
12217 Champlin Dr
Champlin, MN 55316-1930
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 116827400 | Medicaid | MN |
Other providers in Champlin, MN
- Phillip William Berg
- Loren Bergstedt
- Kristi J Berry
- Jay Patrick Bertsch
- Joseph Alan Bertsch
- Betty Care Services LLC
- Amy Bianchi-Rossi
- Bickford of Champlin, LLC
- Bio-Medical Applications of Minnesota, Inc.
- Alexander W Blidi
All providers in Champlin, MN · Internist Chiropractor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.