Individual provider Active NPI

Timothy L Wulfert, D.C.

  • Chiropractor
  • Farmington, MO
National Provider Identifier
1801884630
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CE 005766 Issued in MO
Practice address
1036 E Karsch Blvd
Farmington, MO 63640-3403
Phone
(573) 756-9292
Fax
(573) 756-9292
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 CE 005766 MO Primary

Addresses

Primary practice location

1036 E Karsch Blvd
Farmington, MO 63640-3403

Mailing address

PO Box 242
Farmington, MO 63640-0242
Phone (573) 756-9292

Other identifiers 2

IdentifierTypeStateIssuer
2890OtherMOBCBS
253775OtherMOHEALTHLINK HMO PPO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100908000287 MO Practitioner - Chiropractic 3870617236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1036 E Karsch Blvd
Farmington, MO 63640-3403
Phone (573) 756-9292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CE 005766MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wulfert Chiropractic & Acupuncture PC Chiropractor CurrentSince Dec 31, 1991 Accepting new patients

Locations

1036 E Karsch Blvd
Farmington, MO 63640
Phone (573) 756-9292

Organizations & group practices 1

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1801884630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636400242",
            "telephone_number": "573-756-9292",
            "fax_number": "573-756-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 E KARSCH BLVD",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636403403",
            "telephone_number": "573-756-9292",
            "fax_number": "573-756-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WULFERT",
        "first_name": "TIMOTHY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "CE 005766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2890",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK HMO PPO",
            "identifier": "253775",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.