Individual provider Active NPI

Bryan Thomas Boerjan, DC

  • Chiropractor
  • Pensacola, FL
National Provider Identifier
1194951046
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9889 Issued in FL
Practice address
1101 N 9TH Ave.
Pensacola, FL 32501-3235
Phone
(850) 741-3482
Fax
(833) 740-4325
NPI assigned
Jun 5, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9889 FL Primary

Addresses

Primary practice location

1101 N 9TH Ave.
Pensacola, FL 32501-3235

Mailing address

1101 N 9TH Ave.
Pensacola, FL 32501-3235
Phone (850) 741-3482

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100327000606 FL Practitioner - Chiropractic 5294872875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1101 N 9TH Ave
Pensacola, FL 32501-3235
Phone (850) 738-1515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH9889FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Bryan Boerjan Chiropractic PLLC Chiropractor CurrentSince Nov 4, 2024 Accepting new patients
West Florida Medical Center Clinic PA Past Accepting new patients

Locations

1101 N 9th Ave
Pensacola, FL 32501
Phone (850) 738-1515

Interoperability endpoints

  • Direct secure messaging: bboerjan@gcpi-fl.direct.office.nextgen.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1194951046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N 9TH AVE.",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013235",
            "telephone_number": "850-741-3482",
            "fax_number": "833-740-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N 9TH AVE.",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013235",
            "telephone_number": "850-741-3482",
            "fax_number": "833-740-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOERJAN",
        "first_name": "BRYAN",
        "middle_name": "THOMAS",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-05",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.