Individual provider Active NPI

Neil Tieszen, D.C.

  • Chiropractor
  • Anchorage, AK
National Provider Identifier
1669510673
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
231 Issued in AK
Practice address
1310 E Dimond Blvd
Suite 2
Anchorage, AK 99515-2012
Phone
(907) 677-6345
Fax
(907) 677-6604
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 231 AK Primary

Addresses

Primary practice location

1310 E Dimond Blvd
Suite 2
Anchorage, AK 99515-2012

Mailing address

1310 E Dimond Blvd
Suite 2
Anchorage, AK 99515-2012
Phone (907) 677-6345

Other identifiers 1

IdentifierTypeStateIssuer
231OtherAKPROFESSIONAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100729000300 AK Practitioner - Chiropractic 1456484377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1310 E Dimond Blvd
Suite 2
Anchorage, AK 99515-2031
Phone (907) 677-6345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
231AKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sports & Spinal Injury Clinic, LLC Chiropractor Past Accepting new patients
Sports & Spinal Injury Clinic,LLC Chiropractor PastSince Jun 1, 2010 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1669510673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 E DIMOND BLVD",
            "address_2": "SUITE 2",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995152012",
            "telephone_number": "907-677-6345",
            "fax_number": "907-677-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 E DIMOND BLVD",
            "address_2": "SUITE 2",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995152012",
            "telephone_number": "907-677-6345",
            "fax_number": "907-677-6604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIESZEN",
        "first_name": "NEIL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "231",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.