Bradley Richard Bosma, D.C.
Individual provider Active NPI Chiropractor · Wrightstown, WI
NPI 1366449696 · NPPES record last updated May 24, 2018
Key facts
- NPI
- 1366449696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3807-012 (WI)
- Practice address
- 202 Plum Rd. Ste a
Ste 4
Wrightstown, WI 54180-1253 - Phone
- (920) 532-6450
- NPI assigned
- Jul 1, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
202 Plum Rd a
Wrightstown, WI 54180-1253
Phone (920) 532-6450
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040322000672 | WI | Practitioner - Chiropractic | 3375433279 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3807-012 | WI | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3807-012 | WI | Yes |
Addresses
Primary practice location
202 Plum Rd. Ste a
Ste 4
Wrightstown, WI 54180-1253
Mailing address
202 Plum Rd. Ste a
Wrightstown, WI 54180-1253
Phone (920) 532-6450
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 389-36600 | Medicaid | WI |
Other providers in Wrightstown, WI
- Bel-Regional Home Medical Inc
- Bel-Regional Home Medical Inc
- Bellin Memorial Hospital Inc
- Dulcie R Bosi
- Bosma Chiropractic L.L.C.
- Jordan E Burton
- Ashley E. Callaway
- Dawn Craft
- D&D Chiropractic and Wellness, LLC
- Jennifer D. Degroot
All providers in Wrightstown, WI · Chiropractor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2018. 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.