Charles Thomas Boisen, DC
Individual provider Active NPI Chiropractor · Rochester, MN
NPI 1003974148 · NPPES record last updated May 2, 2008
Key facts
- NPI
- 1003974148
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1549 (MN)
- Practice address
- 1751 N Hwy 52
Rochester, MN 55901 - Phone
- (507) 289-8252
- Fax
- (507) 289-3045
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1979
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
326 Elton Hills Dr NW
Rochester, MN 55901-2476
Phone (507) 289-8252
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120405000097 | MN | Practitioner - Chiropractic | 1456512151 | Practice locations: Rochester, MN |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1549 | MN | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1549 | MN | Yes |
Addresses
Primary practice location
1751 N Hwy 52
Rochester, MN 55901
Mailing address
1751 N Hwy 52
Rochester, MN 55901
Phone (507) 289-8252
NPI Registry JSON
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209686400000",
"number": "1003974148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1751 N HWY 52",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "55901",
"telephone_number": "507-289-8252",
"fax_number": "507-289-3045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1751 N HWY 52",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "55901",
"telephone_number": "507-289-8252",
"fax_number": "507-289-3045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOISEN",
"first_name": "CHARLES",
"middle_name": "THOMAS",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2008-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "1549",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.