Boline Fenstra Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3122 Issued in MN

Legal business name

BOLINE FENSTRA CHIROPRACTIC PC

Practice address

1101 1St St S
Willmar, MN 56201-3592

Phone

(320) 235-0515

NPI assigned

Jun 9, 2008

Organization subpart

No

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

Authorized official

Name

Kendall A Boline FenstraNPI 1033318415

Title

Owner

Phone

(320) 235-0515

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• BOLINE FENSTRA CHIROPRACTIC PC Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kendall A Boline Fenstra, DC

  • Chiropractor
  • Willmar, MN
  • NPI 1033318415
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434672000000",
    "number": "1003075615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 1ST ST S",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013592",
            "telephone_number": "320-235-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 1ST ST S",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013592",
            "telephone_number": "320-235-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLINE FENSTRA CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2015-06-19",
        "status": "A",
        "authorized_official_last_name": "BOLINE FENSTRA",
        "authorized_official_first_name": "KENDALL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-235-0515"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "900022400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BOLINE FENSTRA CHIROPRACTIC PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Blonigan Christianson Chiropractic
• Joan M Blonigan Christianson, DC
• Jasmine Djenaba Blue, LICSW
• Collin John Bohlke
• Thomas Scott Boike, ATC
• Kendall A Boline Fenstra, DC
• Lisa Bolle, RN,CNS
• Rachel Bollerud, LPCC
• Jessica Bonnema
• Michelle Lynn Bonnema, CST CERTIFIED SURGIC

• Chiropractor in Willmar, MN
• Providers in Willmar, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.