Individual provider Active NPI

Timothy Bryan, DC

  • Chiropractor
  • Norwood, MA
National Provider Identifier
1972268936
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3749 Issued in MA
Practice address
99 Access Rd Unit B
Norwood, MA 02062-5211
Phone
(781) 349-5600
NPI assigned
Nov 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3749 MA Primary

Addresses

Primary practice location

99 Access Rd Unit B
Norwood, MA 02062-5211

Mailing address

99 Access Rd Unit B
Norwood, MA 02062-5211
Phone (781) 349-5600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211201002218 MA Practitioner - Chiropractic 4587054820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Breaking Free Chiropractic LLCGroup PAC ID 7214327550, 2 clinicians

Practice addresses (Care Compare)

99 Access Rd
Unit B
Norwood, MA 02062-5211
Phone (781) 349-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3749MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Breaking Free Chiropractic LLC Chiropractor CurrentSince Jan 15, 2021 Accepting new patients

Locations

99 Access Rd
Unit B
Norwood, MA 02062
Phone (781) 349-5600

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": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1972268936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 ACCESS RD UNIT B",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625211",
            "telephone_number": "781-349-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 ACCESS RD UNIT B",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020625211",
            "telephone_number": "781-349-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.