Individual provider Active NPI

Jane F. Bourgeois, D.C., P.C.

  • Chiropractor
  • Iowa City, IA
National Provider Identifier
1245444108
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05956 Issued in IA
Practice address
759 S Gilbert St
Iowa City, IA 52240
Phone
(319) 337-7890
Fax
(319) 337-7890
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05956 IA Primary
Chiropractor 111N00000X 3652 CO
Chiropractor 111N00000X 1367 NM

Addresses

Primary practice location

759 S Gilbert St
Iowa City, IA 52240

Mailing address

759 S Gilbert St
Iowa City, IA 52240
Phone (319) 337-7890

Other identifiers 1

IdentifierTypeStateIssuer
55437OtherIAWELLMARK BLUE CROSS BLUE

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
1367NMMDChiropractor
3652COMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1245444108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 S GILBERT ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52240",
            "telephone_number": "319-337-7890",
            "fax_number": "319-337-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "759 S GILBERT ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "52240",
            "telephone_number": "319-337-7890",
            "fax_number": "319-337-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURGEOIS",
        "first_name": "JANE",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "D.C., P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05956",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "3652",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "1367",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS BLUE",
            "identifier": "55437",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.