Individual provider Active NPI

Dean A Johnson, DC

  • Chiropractor
  • Boulder, CO
National Provider Identifier
1265619548
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3145 Issued in CO
Practice address
4801 Riverbend Rd
Boulder, CO 80301-2613
Phone
(303) 440-6622
Fax
(303) 440-6623
NPI assigned
Jan 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3145 CO Primary

Addresses

Primary practice location

4801 Riverbend Rd
Boulder, CO 80301-2613

Mailing address

4801 Riverbend Rd
Boulder, CO 80301-2613
Phone (303) 440-6622

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051010000917 CO Practitioner - Chiropractic 3072538966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4810 Riverbend Rd
Boulder, CO 80301-2643
Phone (303) 440-6622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3145COMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Downtown Chiropractic Clinic Inc Chiropractor CurrentSince Feb 1, 2006 Accepting new patients

Locations

4801 Riverbend Rd
Boulder, CO 80301
Phone (303) 415-4299

4810 Riverbend Rd
Boulder, CO 80301
Phone (303) 440-6622

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": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236124800000",
    "number": "1265619548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 RIVERBEND RD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012613",
            "telephone_number": "303-440-6622",
            "fax_number": "303-440-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 RIVERBEND RD",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012613",
            "telephone_number": "303-440-6622",
            "fax_number": "303-440-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEAN",
        "middle_name": "A",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-29",
        "last_updated": "2009-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "3145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; 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.