Individual provider Active NPI

Michael Edward Tindall, D.C.

  • Chiropractor
  • Webster City, IA
National Provider Identifier
1639263692
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
05061 Issued in IA
Practice address
1527 Superior St
Webster City, IA 50595-2961
Phone
(515) 832-3033
Fax
(515) 832-1769
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 05061 IA Primary

Addresses

Primary practice location

1527 Superior St
Webster City, IA 50595-2961

Mailing address

1527 Superior St
Webster City, IA 50595-2961
Phone (515) 832-3033

Other identifiers 2

IdentifierTypeStateIssuer
22050OtherIAWELLMARK NUMBER
0220509MedicaidIA

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639263692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 SUPERIOR ST",
            "city": "WEBSTER CITY",
            "state": "IA",
            "postal_code": "505952961",
            "telephone_number": "515-832-3033",
            "fax_number": "515-832-1769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 SUPERIOR ST",
            "city": "WEBSTER CITY",
            "state": "IA",
            "postal_code": "505952961",
            "telephone_number": "515-832-3033",
            "fax_number": "515-832-1769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINDALL",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "05061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK NUMBER",
            "identifier": "22050",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0220509",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster City, IA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.