Michael D Boerner, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHR.0005699 Issued in CO

Practice address

10465 Melody Drive
Suite 303
Northglenn, CO 80234-4125

Phone

(303) 335-9306

Fax

(866) 459-2576

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1194741843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10465 MELODY DRIVE",
            "address_2": "SUITE 303",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "80234",
            "telephone_number": "303-335-9306",
            "fax_number": "866-459-2576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10465 MELODY DRIVE",
            "address_2": "SUITE 303",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802344125",
            "telephone_number": "303-335-9306",
            "fax_number": "866-459-2576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERNER",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CO",
            "license": "EL.2782841",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CO",
            "license": "CHR.0005699",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CO",
            "license": "AC.2786126",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR.0005699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Northglenn, CO
• Providers in Northglenn, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.