Kelsey Leigh Boetcher, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

B01874 Issued in NV

Practice address

6900 N Pecos Rd
North Las Vegas, NV 89086-4400

Phone

(612) 280-6781

NPI assigned

Nov 15, 2018

Last updated

Aug 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elevate Sports Performance and Rehab, LLC

  dba Elevate Sports Performance & Healthcare

  • Chiropractor
  • Las Vegas, NV
  • NPI 1518483262
  NPD
• Kick Performance Therapy LLC

  • Physical Therapist
  • Portland, OR
  • NPI 1235881178
  NPD (past)
• Shena Vander Ploeg ND PC

  • Health Maintenance Organization
  • Portland, OR
  • NPI 1083019723
  NPD (past)

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1295204634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10909 S EASTERN AVE",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525864",
            "telephone_number": "702-558-2151",
            "fax_number": "702-579-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 N PECOS RD",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890864400",
            "telephone_number": "612-280-6781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "905 SE Ankeny St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972141349",
            "country_code": "US",
            "telephone_number": "971-236-7610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2905 SW Cedar Hills Blvd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970051342",
            "country_code": "US",
            "telephone_number": "971-217-8806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10909 S Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890525864",
            "country_code": "US",
            "telephone_number": "702-558-2151",
            "fax_number": "702-579-9877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOETCHER",
        "first_name": "KELSEY",
        "middle_name": "LEIGH",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5898",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NV",
            "license": "B01874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Chiropractor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.