James Robert Boots, DC
Individual provider Active NPI Chiropractor · Kimberly, WI
NPI 1356417067 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1356417067
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2055012 (WI)
- Practice address
- 1020 Truman Street
Suite B
Kimberly, WI 54136 - Phone
- (920) 997-9700
- Fax
- (920) 997-0060
- NPI assigned
- Nov 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Boots Chiropractic and Wellness Center, S.C.
Practice addresses (Care Compare)
1020 Truman St
Suite B
Kimberly, WI 54136-2215
Phone (920) 997-9700
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101209000151 | WI | Practitioner - Chiropractic | 6305970963 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2055012 | WI | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2055012 | WI | Yes |
Addresses
Primary practice location
1020 Truman Street
Suite B
Kimberly, WI 54136
Mailing address
1020 Truman Street
Suite B
Kimberly, WI 54136
Phone (920) 997-9700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38792900 | Medicaid | WI |
Other providers in Kimberly, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.