Individual provider Active NPI

Thomas Leo Tegels, DC

  • Chiropractor
  • Windom, MN
National Provider Identifier
1629067129
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1702 Issued in MN
Practice address
601 4TH Ave
Windom, MN 56101-1652
Phone
(507) 831-2460
Fax
(507) 831-2164
NPI assigned
Oct 18, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1702 MN Primary

Addresses

Primary practice location

601 4TH Ave
Windom, MN 56101-1652

Mailing address

601 4TH Ave
Windom, MN 56101-1652
Phone (507) 831-2460

Other identifiers 1

IdentifierTypeStateIssuer
147827300MedicaidMN

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
1704MNMDRehabilitation Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1629067129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 4TH AVE",
            "city": "WINDOM",
            "state": "MN",
            "postal_code": "561011652",
            "telephone_number": "507-831-2460",
            "fax_number": "507-831-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 4TH AVE",
            "city": "WINDOM",
            "state": "MN",
            "postal_code": "561011652",
            "telephone_number": "507-831-2460",
            "fax_number": "507-831-2164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEGELS",
        "first_name": "THOMAS",
        "middle_name": "LEO",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147827300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windom, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.

Verify at the official NPI Registry.