Individual provider Active NPI

Thaddeus C Bosman, D.C.

  • Chiropractor
  • Twinsburg, OH
National Provider Identifier
1215089107
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC1174 Issued in OH
Practice address
8984 Darrow Rd
Twinsburg, OH 44087-2186
Phone
(330) 425-2101
Fax
(330) 963-0478
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC1174 OH Primary

Addresses

Primary practice location

8984 Darrow Rd
Twinsburg, OH 44087-2186

Mailing address

8984 Darrow Rd
Twinsburg, OH 44087-2186
Phone (330) 425-2101

Other identifiers 5

IdentifierTypeStateIssuer
000000136035OtherOHANTHEM PIN NUMBER
341657278OtherOHCOMMERCIAL INSURANCE PIN
P00319931OtherOHRAILROAD MEDICARE PIN
0655643MedicaidOH
34165727800OtherOHWORKERS' COMPENSATION PIN

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
DC1174OHMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Twinsburg Chiropractic Center Chiropractor PastSince Oct 1, 2017 Accepting new patients

Organizations & group practices 1

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1215089107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8984 DARROW RD",
            "city": "TWINSBURG",
            "state": "OH",
            "postal_code": "440872186",
            "telephone_number": "330-425-2101",
            "fax_number": "330-963-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8984 DARROW RD",
            "city": "TWINSBURG",
            "state": "OH",
            "postal_code": "440872186",
            "telephone_number": "330-425-2101",
            "fax_number": "330-963-0478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSMAN",
        "first_name": "THADDEUS",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC1174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN NUMBER",
            "identifier": "000000136035",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCE PIN",
            "identifier": "341657278",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00319931",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0655643",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS' COMPENSATION PIN",
            "identifier": "34165727800",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twinsburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.