Active NPI
Dustin Charles Jerome Bosson, DC
- Chiropractor
- Dardenne Prairie, MO
National Provider Identifier
1063942415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2017015434
- Practice address
- 7827 Highway N Ste 102
Dardenne Prairie, MO 63368-7199 - Phone
- (636) 486-6933
- NPI assigned
- Jun 19, 2017
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2017015434 | MO | Primary |
Addresses
Primary practice location
7827 Highway N Ste 102
Dardenne Prairie, MO 63368-7199
Mailing address
151 Shadalane Walk
Ballwin, MO 63011-3045
Phone (636) 328-6693
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017015434 | MO | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497830400000",
"number": "1063942415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 SHADALANE WALK",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630113045",
"telephone_number": "636-328-6693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7827 HIGHWAY N STE 102",
"city": "DARDENNE PRAIRIE",
"state": "MO",
"postal_code": "633687199",
"telephone_number": "636-486-6933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSSON",
"first_name": "DUSTIN",
"middle_name": "CHARLES JEROME",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-19",
"last_updated": "2017-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MO",
"license": "2017015434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dardenne Prairie, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.