Individual provider Active NPI

Chad David Buohl, D.C.

  • Sports Physician Chiropractor
  • East Berlin, PA
National Provider Identifier
1386613925
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC007552L Issued in PA
Practice address
337 W King St
East Berlin, PA 17316-9730
Phone
(717) 259-8813
Fax
(717) 259-0988
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X DC007552L PA Primary

Addresses

Primary practice location

337 W King St
East Berlin, PA 17316-9730

Mailing address

PO Box 1010
East Berlin, PA 17316-1010
Phone (717) 259-8813

Other identifiers 6

IdentifierTypeStateIssuer
10923906OtherPATRIAD
50030447OtherPABLUE CROSS
3000240OtherPAHMO KEYSTONE
50030444OtherPAKEYSTONE BC HMO
903165OtherPAHIGHMARK BLUE SHIELD
3478163OtherPAAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040315000153 PA Practitioner - Chiropractic 8628967932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

337 W King St
East Berlin Chiropractic
East Berlin, PA 17316-9730
Phone (717) 259-8813

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC007552LPAMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chad D. Buohl, PC Sports Physician CurrentSince Jan 1, 2004 Accepting new patients
Dr. James D. Spertzel Sports Physician Past Accepting new patients

Organizations & group practices 2

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386613925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1010",
            "city": "EAST BERLIN",
            "state": "PA",
            "postal_code": "173161010",
            "telephone_number": "717-259-8813",
            "fax_number": "717-259-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 W KING ST",
            "city": "EAST BERLIN",
            "state": "PA",
            "postal_code": "173169730",
            "telephone_number": "717-259-8813",
            "fax_number": "717-259-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUOHL",
        "first_name": "CHAD",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "PA",
            "license": "DC007552L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIAD",
            "identifier": "10923906",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "50030447",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO KEYSTONE",
            "identifier": "3000240",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE BC HMO",
            "identifier": "50030444",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "903165",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3478163",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Berlin, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.