Individual provider Active NPI

Brian R Timms, DC

  • Chiropractor
  • Vancouver, WA
National Provider Identifier
1922370469
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH60822653 Issued in WA
Practice address
1412 NE 134TH St Ste 100
Vancouver, WA 98685
Phone
(360) 574-6594
Fax
(360) 574-2235
NPI assigned
Jan 30, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA60143913 WA
Chiropractor 111N00000X CH60822653 WA Primary

Addresses

Primary practice location

1412 NE 134TH St Ste 100
Vancouver, WA 98685

Mailing address

5707 NE 62ND Cir
Vancouver, WA 98661-1582
Phone (360) 560-3131

Other practice location 1

1157 3rd Ave Ste 145
Longview, WA 98632-6004
Phone (360) 575-8897

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180315000302 WA Practitioner - Chiropractic 2769744507 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1404 NE 134TH St
Suite 170
Vancouver, WA 98685-2791
Phone (360) 574-6594

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH60822653WAMDChiropractor
MA60143913WAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Daren D. Bowlby DC PS Chiropractor CurrentSince Mar 6, 2018 Accepting new patients
Timms Family Chiropractic, PLLC Chiropractor CurrentSince Jan 10, 2019 Accepting new patients

Locations

1157 3rd Ave
Ste 145
Longview, WA 98632
Phone (360) 295-2828

1412 NE 134th St
Ste 100
Vancouver, WA 98685
Phone (360) 574-1920

1404 NE 134th St
Ste 170
Vancouver, WA 98685
Phone (360) 573-1381

Organizations & group practices 2

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": "1327881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1922370469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5707 NE 62ND CIR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986611582",
            "telephone_number": "360-560-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 NE 134TH ST STE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98685",
            "telephone_number": "360-574-6594",
            "fax_number": "360-574-2235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1157 3rd Ave Ste 145",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986326004",
            "country_code": "US",
            "telephone_number": "360-575-8897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMMS",
        "first_name": "BRIAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-30",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60143913",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60822653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.