Active NPI
Gregory R Tickle, DC
- Chiropractor
- Narberth, PA
National Provider Identifier
1508949744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC006360L
- Practice address
- 104 Forrest Ave
Narberth, PA 19072-2215 - Phone
- (610) 667-8412
- Fax
- (610) 667-8413
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC006360L | PA | Primary |
Addresses
Primary practice location
104 Forrest Ave
Narberth, PA 19072-2215
Mailing address
104 Forrest Ave
Narberth, PA 19072-2215
Phone (610) 667-8412
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
| License | State | Type | Specialty |
|---|---|---|---|
| DC006360L | PA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249603200000",
"number": "1508949744",
"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": "GREGORY",
"middle_name": "R",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2009-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC006360L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Narberth, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.