NPIMap

Organization Active NPI

Back in Motion Chiropractic Kristin Bodenbender, D.C., Inc.

  • Chiropractor
  • Costa Mesa, CA
National Provider Identifier
1437478237
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC24289 Issued in CA
Legal business name
BACK IN MOTION CHIROPRACTIC KRISTIN BODENBENDER, D.C., INC.
Practice address
2850 Mesa Verde Dr E
Suite K
Costa Mesa, CA 92626-4891
Phone
(714) 434-2585
Fax
(866) 390-2850
NPI assigned
May 19, 2010
Last updated
Dec 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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

Authorized official

Name
Kristin M Bodenbender, D.C.NPI 1770781213
Title
Owner / Provider
Phone
(714) 434-2585

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC24289 CA Primary

Addresses

Primary practice location

2850 Mesa Verde Dr E
Suite K
Costa Mesa, CA 92626-4891

Mailing address

2850 Mesa Verde Dr E
Suite K
Costa Mesa, CA 92626-4891
Phone (714) 434-2585

Other names 1

  • Back In Motion, Inc. Former legal business name

National Provider Directory

National Provider Directory

Locations

440 Fair Dr
Ste Q
Costa Mesa, CA 92626
Phone (714) 434-2585

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323216000000",
    "number": "1437478237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 MESA VERDE DR E",
            "address_2": "SUITE K",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264891",
            "telephone_number": "714-434-2585",
            "fax_number": "866-390-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 MESA VERDE DR E",
            "address_2": "SUITE K",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264891",
            "telephone_number": "714-434-2585",
            "fax_number": "866-390-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK IN MOTION CHIROPRACTIC KRISTIN BODENBENDER, D.C., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-19",
        "last_updated": "2011-12-07",
        "status": "A",
        "authorized_official_last_name": "BODENBENDER",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER / PROVIDER",
        "authorized_official_telephone_number": "714-434-2585",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC24289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Back In Motion, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.