Organization Active NPI

Bos Chiropractic, PLLC

  • Chiropractor
  • Chandler, AZ
National Provider Identifier
1417145202
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5999 Issued in AZ
Legal business name
BOS CHIROPRACTIC, PLLC
Practice address
793 N Alma School Rd
Suite D5
Chandler, AZ 85224-3681
Phone
(480) 732-1000
Fax
(480) 323-2867
NPI assigned
Oct 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Authorized official

Name
Willem E Bos, D.C.NPI 1821299215
Title
Sole Member
Phone
(480) 732-1000

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 5999 AZ Primary

Addresses

Primary practice location

793 N Alma School Rd
Suite D5
Chandler, AZ 85224-3681

Mailing address

793 N Alma School Rd
Suite D5
Chandler, AZ 85224-3681
Phone (480) 732-1000

Other identifiers 2

IdentifierTypeStateIssuer
1821299215OtherAZPERSONAL NPI - WILLEM BOS
AZ0939730OtherBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050614001499 AZ Part B Supplier - Clinic/Group Practice 4385686567 Receives reassigned benefits from 1 practitioner
Practice locations: Chandler, AZ

National Provider Directory

National Provider Directory

Locations

793 N Alma School Rd
Ste D5
Chandler, AZ 85224
Phone (480) 732-1000

1840 W Chandler Blvd
Ste 1
Chandler, AZ 85224
Phone (480) 732-1000

Practitioners & affiliated clinicians

Practitioners 2

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": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1417145202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 N ALMA SCHOOL RD",
            "address_2": "SUITE D5",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243681",
            "telephone_number": "480-732-1000",
            "fax_number": "480-323-2867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 N ALMA SCHOOL RD",
            "address_2": "SUITE D5",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243681",
            "telephone_number": "480-732-1000",
            "fax_number": "480-323-2867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOS CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "BOS",
        "authorized_official_first_name": "WILLEM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "480-732-1000",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI - WILLEM BOS",
            "identifier": "1821299215",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0939730",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.