Individual provider Active NPI

Thomas E Botz II, DC

  • Chiropractor
  • Manhattan, KS
National Provider Identifier
1104811728
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0103890 Issued in KS
Practice address
445 E Poyntz Ave
Manhattan, KS 66502-5045
Phone
(785) 776-1600
Fax
(785) 776-1625
NPI assigned
Sep 20, 2005
Last updated
Nov 29, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0103890 KS Primary

Addresses

Primary practice location

445 E Poyntz Ave
Manhattan, KS 66502-5045

Mailing address

445 E Poyntz Ave
Manhattan, KS 66502-5045
Phone (785) 776-1600

Other identifiers 1

IdentifierTypeStateIssuer
0103890OtherLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040914000229 KS Practitioner - Chiropractic 6507832417 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0103890KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spinal Structural Rehabilitation Center Inc Chiropractor CurrentSince Apr 29, 2004 Accepting new patients
John M Wertin D C P a Chiropractor Past Accepting new patients

Locations

445 E Poyntz Ave
Manhattan, KS 66502
Phone (785) 776-1600

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1104811728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 E POYNTZ AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665025045",
            "telephone_number": "785-776-1600",
            "fax_number": "785-776-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 E POYNTZ AVE",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665025045",
            "telephone_number": "785-776-1600",
            "fax_number": "785-776-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTZ",
        "first_name": "THOMAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "0103890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "0103890",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; 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.