Andrea L Tickle, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC006357L Issued in PA

Practice address

104 Forrest Ave
Narberth, PA 19072-2215

Phone

(610) 667-8412

Fax

(610) 667-8413

NPI assigned

Oct 23, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Jersey Family Medical Centers, IncGroup PAC ID 0547170763, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Southern Jersey Family Medical Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Hammonton, NJ
  • NPI 1568473973
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497838635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 FORREST AVE",
            "city": "NARBERTH",
            "state": "PA",
            "postal_code": "190722215",
            "telephone_number": "610-667-8412",
            "fax_number": "610-667-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FORREST AVE",
            "city": "NARBERTH",
            "state": "PA",
            "postal_code": "190722215",
            "telephone_number": "610-667-8412",
            "fax_number": "610-667-8413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICKLE",
        "first_name": "ANDREA",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC006357L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wedad Taeb
• Elizabeth Marie Talvacchia, OTR/L
• Allan N. Tannenbaum, PH.D.
• Marcella Ruth Tanney, LMT
• Therapy Central LLC
• Gregory R Tickle, DC
• Kristine Tomlinson
• Sarah Ullman, PHD
• Pamela Vantassel, MD
• Marjorie Kozart Volpp, MSS, LCSW

• Chiropractor in Narberth, PA
• Providers in Narberth, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.