Timothy W Stark, DC DACBSP ICSSD CSCS

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

647 Issued in ND

Practice address

715 13TH Ave E
Suite 101
West Fargo, ND 58078-3380

Phone

(701) 492-0696

Fax

(701) 492-0696

NPI assigned

Sep 22, 2008

Last updated

Sep 22, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Sweere Clinic LLC

  • Clinic/Center
  • Bloomington, MN
  • NPI 1942778097
  NPD
• Clinic FHSC PC

  • Clinic/Center
  • West Fargo, ND
  • NPI 1023286614
  NPD (past)
• Dr. J Gregory Dye, P.C.

  dba Family Vision

  • Optometrist
  • West Fargo, ND
  • NPI 1720140577
  NPD (past)

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222041600000",
    "number": "1811147325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 13TH AVE E",
            "address_2": "SUITE 101",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580783380",
            "telephone_number": "701-492-0696",
            "fax_number": "701-492-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 13TH AVE E",
            "address_2": "SUITE 101",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580783380",
            "telephone_number": "701-492-0696",
            "fax_number": "701-492-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "TIMOTHY",
        "middle_name": "W",
        "credential": "DC DACBSP ICSSD CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-22",
        "last_updated": "2008-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "ND",
            "license": "647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SSS PLLC
• Leah Staahl, PT
• Jerrica Stack
• Penny Jean Stadick, HHP,CCAP, CNC, CH
• Chasity Stanczyk
• Amber Steenstrup
• Erin Stephany
• Allison Stickel
• Seth Jared Stofferahn, OD
• Jessica Kay Stolle Anderson

• Sports Physician Chiropractor in West Fargo, ND
• Providers in West Fargo, ND by specialty
• Sports Physician Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.