Individual provider Active NPI

Thomas Niemela, DC

  • Chiropractor
  • Bentonville, AR
National Provider Identifier
1851746747
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
16124 Issued in AR
Practice address
1401 S Walton Blvd Ste 25
Bentonville, AR 72712-6139
Phone
(479) 208-6766
Fax
(479) 435-7120
NPI assigned
Apr 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 16124 AR Primary

Addresses

Primary practice location

1401 S Walton Blvd Ste 25
Bentonville, AR 72712-6139

Mailing address

1401 S Walton Blvd Ste 25
Bentonville, AR 72712-6139
Phone (479) 208-6766

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160509002040 AR Practitioner - Chiropractic 0749589018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1401 S Walton Blvd
Suite 25
Bentonville, AR 72712-6139
Phone (479) 208-6766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arbor Vitae Chiropractic Inc Chiropractor CurrentSince Apr 29, 2015 Accepting new patients

Locations

201 SW 14th St
Ste 103
Bentonville, AR 72712
Phone (479) 208-6766

1401 S Walton Blvd
Ste 25
Bentonville, AR 72712
Phone (479) 208-6766

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": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1851746747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S WALTON BLVD STE 25",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727126139",
            "telephone_number": "479-208-6766",
            "fax_number": "479-435-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S WALTON BLVD STE 25",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727126139",
            "telephone_number": "479-208-6766",
            "fax_number": "479-435-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMELA",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-28",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "16124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; 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.