Individual provider Active NPI

Lynn Marie Boelger, D.C.

  • Chiropractor
  • Davenport, IA
National Provider Identifier
1184810772
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05200 Issued in IA
Practice address
2542 E 46TH St
Davenport, IA 52807-1520
Phone
(563) 210-8456
Fax
(563) 293-7570
NPI assigned
Sep 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05200 IA Primary

Addresses

Primary practice location

2542 E 46TH St
Davenport, IA 52807-1520

Mailing address

2542 E 46TH St
Davenport, IA 52807-1520
Phone (563) 210-8456

Other practice location 1

4711 N Brady St Ste 24
Davenport, IA 52806-3969
Phone (563) 210-8456

Other names 1

  • Dr. Lynn Marie Boelger Other name

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

LicenseStateTypeSpecialty
A05200IAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1184810772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2542 E 46TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071520",
            "telephone_number": "563-210-8456",
            "fax_number": "563-293-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2542 E 46TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071520",
            "telephone_number": "563-210-8456",
            "fax_number": "563-293-7570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4711 N Brady St Ste 24",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528063969",
            "country_code": "US",
            "telephone_number": "563-210-8456",
            "fax_number": "563-293-7570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOELGER",
        "first_name": "LYNN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "BOELGER",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; 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.