Individual provider Active NPI

Timothy Patrick Fetter, D.C., M.S.W.

  • Chiropractor
  • Greensburg, PA
National Provider Identifier
1801178298
Registry record updated Dec 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC010456 Issued in PA
Practice address
820 S Main St Ste 1B
Greensburg, PA 15601-4139
Phone
(724) 832-6700
Fax
(724) 832-6711
NPI assigned
Sep 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Chiropractor 111N00000X DC010456 PA Primary

Addresses

Primary practice location

820 S Main St Ste 1B
Greensburg, PA 15601-4139

Mailing address

820 S Main St Ste 1B
Greensburg, PA 15601-4139
Phone (724) 832-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120119000635 PA Practitioner - Chiropractic 7810164647 Reassigns benefits to 1 organization
I20240910001582 IL Practitioner - Chiropractic 7810164647 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bompiani Spine & Sport LLC Chiropractor CurrentSince Oct 13, 2025 Accepting new patients
Active Wellness LLC Chiropractor CurrentSince Jul 29, 2024 Accepting new patients
Active Wellness, LLC Chiropractor CurrentSince Jul 29, 2024 Accepting new patients

Locations

4555 N Lincoln Ave
Chicago, IL 60625
Phone (773) 328-8153

5840 State Route 981
Ste 101
Latrobe, PA 15650
Phone (724) 240-3016

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": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1801178298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S MAIN ST STE 1B",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156014139",
            "telephone_number": "724-832-6700",
            "fax_number": "724-832-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S MAIN ST STE 1B",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156014139",
            "telephone_number": "724-832-6700",
            "fax_number": "724-832-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTER",
        "first_name": "TIMOTHY",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.C., M.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC010456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.

Verify at the official NPI Registry.