Timothy J Hamp, DC FASA
Individual provider Active NPI Chiropractor · Fairmont, MN
NPI 1649239161 · NPPES record last updated Sep 22, 2014
Key facts
- NPI
- 1649239161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2034 (MN)
- Practice address
- 1125 Spruce St
Fairmont, MN 56031-4410 - Phone
- (507) 235-6629
- Fax
- (507) 235-6620
- NPI assigned
- Mar 22, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1983
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1125 Spruce St
Fairmont, MN 56031-4410
Phone (507) 235-6629
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110302000360 | MN | Practitioner - Chiropractic | 9739360454 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2034 | MN | MD | Mental Health Counselor |
| 223 | MN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairmont Chiropractic & Acupuncture Healthcare, LTD | Chiropractor | Current |
Accepting new patients |
Locations
1125 Spruce St
Fairmont, MN 56031
Phone (507) 235-6629
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2034 | MN | Yes |
| Acupuncturist | 171100000X | 223 | MN |
Addresses
Primary practice location
1125 Spruce St
Fairmont, MN 56031-4410
Mailing address
1125 Spruce St
Fairmont, MN 56031-4410
Phone (507) 235-6629
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42215HA | Other | MN | BCBS |
Other providers in Fairmont, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2014. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.