Active NPI
Barbara L. Bosch, M.D.
- Pediatrics Physician
- Flagstaff, AZ
National Provider Identifier
1053303321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 32739
- Practice address
- 77 W Forest Ave
Suite 304
Flagstaff, AZ 86001-1479 - Phone
- (928) 214-3600
- Fax
- (928) 214-3601
- NPI assigned
- Aug 22, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 32739 | AZ | Primary |
Addresses
Primary practice location
77 W Forest Ave
Suite 304
Flagstaff, AZ 86001-1479
Mailing address
77 W Forest Ave
Suite 304
Flagstaff, AZ 86001-1479
Phone (928) 214-3600
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 856495 | Medicaid | AZ | |
| 0753850 | Other | AZ | BCBS |
| 5217269 | Other | AZ | CIGNA |
| 2Z1003 | Other | AZ | HEALTH NET |
| 5592602 | Other | AZ | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32739 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311292800000",
"number": "1053303321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 W FOREST AVE",
"address_2": "SUITE 304",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860011479",
"telephone_number": "928-214-3600",
"fax_number": "928-214-3601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 W FOREST AVE",
"address_2": "SUITE 304",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860011479",
"telephone_number": "928-214-3600",
"fax_number": "928-214-3601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSCH",
"first_name": "BARBARA",
"middle_name": "L.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-08-22",
"last_updated": "2011-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "32739",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "856495",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0753850",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "5217269",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET",
"identifier": "2Z1003",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5592602",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.