Individual provider Active NPI

Tyler William Dombrowski, DC

  • Chiropractor
  • State College, PA
National Provider Identifier
1891324596
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC011542 Issued in PA
Practice address
450 Windmere Dr Ste 250
State College, PA 16801-7646
Phone
(814) 954-5095
Fax
(814) 308-8369
NPI assigned
Apr 4, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC011542 PA Primary

Addresses

Primary practice location

450 Windmere Dr Ste 250
State College, PA 16801-7646

Mailing address

450 Windmere Dr Ste 250
State College, PA 16801-7646
Phone (814) 954-5095

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL 1891104196 Direct
Other URL Computer Direct

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

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Hills Chiropractic Health Center, P.C. Chiropractor PastSince Apr 1, 2005 Accepting new patients

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": "1585958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1891324596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 WINDMERE DR STE 250",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017646",
            "telephone_number": "814-954-5095",
            "fax_number": "814-308-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WINDMERE DR STE 250",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017646",
            "telephone_number": "814-954-5095",
            "fax_number": "814-308-8369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMBROWSKI",
        "first_name": "TYLER",
        "middle_name": "WILLIAM",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-04",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC011542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "1891104196",
            "affiliation": "N",
            "endpointDescription": "Reynoldsville Chiropractic Life Center, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "105 E Main St",
            "city": "Reynoldsville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "158511244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Computer",
            "affiliation": "N",
            "endpointDescription": "Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "105 E Main St",
            "city": "Reynoldsville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "158511244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.