Bradley James Boulton, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301005243 Issued in MI

Practice address

190 S Second St
Harrison, MI 48625

Phone

(989) 539-5201

NPI assigned

Oct 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Networks

• IL HMO C-SNP
• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
• devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
• OH PPO

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003905241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "HARRISON",
            "state": "MI",
            "postal_code": "486250308",
            "telephone_number": "989-539-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 S SECOND ST",
            "city": "HARRISON",
            "state": "MI",
            "postal_code": "48625",
            "telephone_number": "989-539-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULTON",
        "first_name": "BRADLEY",
        "middle_name": "JAMES",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cammeron Marie Bentley
• Susan Bentley
• Brandi Bills, MA LPC
• Harold L Bobo Jr.
• Rebecca Ann Boucher
• Blane Bowen, DDS
• Marisa Bowie
• Jennifer Burch
• Lisa Renee Bush
• Care Connections Home Services

• Chiropractor in Harrison, MI
• Providers in Harrison, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.