Active NPI
William M Tsoubanos, D.C.
- Chiropractor
- Conshohocken, PA
National Provider Identifier
1669409744
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC002450
- Practice address
- 815 Fayette St
Conshohocken, PA 19428-1785 - Phone
- (610) 828-2500
- Fax
- (610) 834-7822
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- Sole proprietor
- No
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 | DC002450 | PA | Primary |
Addresses
Primary practice location
815 Fayette St
Conshohocken, PA 19428-1785
Mailing address
815 Fayette St
Conshohocken, PA 19428-1785
Phone (610) 828-2500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081231000285 | PA | Practitioner - Chiropractic | 1557423423 |
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": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193097600000",
"number": "1669409744",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "815 FAYETTE ST",
"city": "CONSHOHOCKEN",
"state": "PA",
"postal_code": "194281785",
"telephone_number": "610-828-2500",
"fax_number": "610-834-7822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 FAYETTE ST",
"city": "CONSHOHOCKEN",
"state": "PA",
"postal_code": "194281785",
"telephone_number": "610-828-2500",
"fax_number": "610-834-7822"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TSOUBANOS",
"first_name": "WILLIAM",
"middle_name": "M",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-26",
"last_updated": "2007-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC002450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conshohocken, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.