Individual provider Active NPI

James William Tickel, D.C.

  • Chiropractor
  • Charlottesville, VA
National Provider Identifier
1851510333
Registry record updated Jun 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104557207 Issued in VA
Practice address
409 8TH St NE
Charlottesville, VA 22902-4727
Phone
(434) 260-6463
NPI assigned
Apr 24, 2007
Last updated
Jun 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.010926 IL
Chiropractor 111N00000X 0104557207 VA Primary

Addresses

Primary practice location

409 8TH St NE
Charlottesville, VA 22902-4727

Mailing address

409 8TH St NE
Charlottesville, VA 22902-4727
Phone (434) 260-6463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.010926ILMDChiropractor
0104557207VAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
New Life Chiropractic, PC Chiropractor CurrentSince Jul 29, 2013 Accepting new patients
Reimagine Mental Health CurrentSince Mar 6, 2022 Accepting new patients
New Life Health & Wellness LLC Chiropractor PastSince Jul 29, 2013 Accepting new patients

Locations

1335 Lily Cache Ln
Bolingbrook, IL 60490
Phone (630) 226-9922

409 8th St NE
Charlottesville, VA 22902
Phone (434) 260-1283

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466208000000",
    "number": "1851510333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 8TH ST NE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229024727",
            "telephone_number": "434-260-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 8TH ST NE",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229024727",
            "telephone_number": "434-260-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICKEL",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2016-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.010926",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2016; 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.