Nicole Kristine Boerboom, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

8104 Issued in AZ

Practice address

1801 W Queen Creek Rd
#2
Chandler, AZ 85248-3001

Phone

(630) 660-4436

NPI assigned

Mar 3, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Chandler Family Chiropractic & Rehab, PLLC

  • Chiropractor
  • Chandler, AZ
  • NPI 1609187335
  Authorized official Same address or phone

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276819200000",
    "number": "1184894594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W QUEEN CREEK RD",
            "address_2": "#2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852483001",
            "telephone_number": "630-660-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W QUEEN CREEK RD",
            "address_2": "#2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852483001",
            "telephone_number": "630-660-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERBOOM",
        "first_name": "NICOLE",
        "middle_name": "KRISTINE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2010-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011011",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carley Boden, RN
• Bodhi Body Integrative Medical Centers
• Body by Doc LLC
• Body Healing Studios, LLC
• Bodyworks Chiropractic & Wellness Center Inc.
• Jocelyn Correlle Bogar, SLPA
• Marilyn P Bogash, MHS
• Ann Caine Bogle, PH.D.
• Karl Edward Bohman, D.D.S.
• Zachary R Boisselle

• Chiropractor in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Chiropractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; 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.