Jason Bollenbaugh, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2614 Issued in TN

Practice address

2191 Hillsboro Rd
Suite a
Franklin, TN 37069-6223

Phone

(618) 420-0409

Fax

(615) 465-6682

NPI assigned

Jul 7, 2005

Sex

Male

Sole proprietor

No

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.

• Advantage Physical Medicine PLLC

  • Integrative Medicine Physician
  • Breese, IL
  • NPI 1568226553
  NPD (past)
• Midwest Chiropractic Clinic of Pittsfield, LTD

  • Chiropractor
  • Pittsfield, IL
  • NPI 1477690865
  NPD (past)
• Revermann Chiropractic P.C.

  • Chiropractor
  • Breese, IL
  • NPI 1679679286
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 12, 2014.

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402531200000",
    "number": "1245237189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 HILLSBORO RD",
            "address_2": "SUITE A",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370696223",
            "telephone_number": "618-420-0409",
            "fax_number": "615-465-6682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 HILLSBORO RD",
            "address_2": "SUITE A",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370696223",
            "telephone_number": "618-420-0409",
            "fax_number": "615-465-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLENBAUGH",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2014-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009505",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN - INDIVIDUAL",
            "identifier": "210868001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC#",
            "identifier": "681087",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS GROUP MCC",
            "identifier": "7521142",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "620543",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP - MCC",
            "identifier": "210868",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID - MCC",
            "identifier": "37-1361254",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "601151600",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Michael Bohunicky, PA
• Christopher M Boles, D.C.
• Suzanne Boles, RDN, LDN
• Lance W Bolin, PA-C
• Callann Lane Bolinger, SUPERVISED MFT
• Emily Bolthouse, PT, DPT, SCS, CSCS
• Sara Bomar, M.D.
• Pauleatha Vernee Diggs Bonds, MD
• Bone and Joint Institute of Tennessee Inc
• Bone and Joint Institute of Tennessee Surgery Center LLC

• All providers in Franklin, TN
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2014; 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.