Organization Active NPI

Boeck Chiropractic Clinic, PA

  • Chiropractor
  • New Bern, NC
National Provider Identifier
1417044652
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2434 Issued in NC
Legal business name
BOECK CHIROPRACTIC CLINIC, PA
Practice address
2602 Neuse Blvd
New Bern, NC 28562-2846
Phone
(252) 634-3111
Fax
(252) 634-3040
NPI assigned
Oct 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Dr. Thomas Paul Boeck, D.C.NPI 1669450409
Title
President
Phone
(252) 634-3111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2434 NC Primary

Addresses

Primary practice location

2602 Neuse Blvd
New Bern, NC 28562-2846

Mailing address

2602 Neuse Blvd
New Bern, NC 28562-2846
Phone (252) 634-3111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101021001342 NC Part B Supplier - Clinic/Group Practice 3678766615 Receives reassigned benefits from 2 practitioners
Practice locations: New Bern, NC

National Provider Directory

National Provider Directory

Locations

1910 S Glenburnie Rd
New Bern, NC 28562
Phone (252) 634-3111

2602 Neuse Blvd
New Bern, NC 28562
Phone (252) 634-3111

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1417044652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 NEUSE BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622846",
            "telephone_number": "252-634-3111",
            "fax_number": "252-634-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 NEUSE BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285622846",
            "telephone_number": "252-634-3111",
            "fax_number": "252-634-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOECK CHIROPRACTIC CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "BOECK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-634-3111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.