Individual provider Active NPI

Joshua B Luitjohan, DC

  • Chiropractor
  • Boulder, CO
National Provider Identifier
1437645231
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHR.0007868 Issued in CO
Practice address
2625 28TH St Ste 100
Boulder, CO 80301-1263
Phone
(303) 402-1300
NPI assigned
Jul 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHR.0007868 CO Primary

Addresses

Primary practice location

2625 28TH St Ste 100
Boulder, CO 80301-1263

Mailing address

2625 28TH St Ste 100
Boulder, CO 80301-1263
Phone (303) 402-1300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240127000157 MO Practitioner - Chiropractic 9830542778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Louis Optimal Performance, LLCGroup PAC ID 7517106008, 2 clinicians

Practice addresses (Care Compare)

219 Chesterfield Towne Ctr
Chesterfield, MO 63005-1257
Phone (636) 778-9997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHR.0007868COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
St. Louis Optimal Performance, LLC Chiropractor CurrentSince Jan 8, 2024 Accepting new patients
Canyon Chiropractic Center PC Chiropractor Past Accepting new patients

Locations

219 Chesterfield Towne Ctr
Chesterfield, MO 63005
Phone (636) 346-1079

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": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1437645231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 28TH ST STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011263",
            "telephone_number": "303-402-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 28TH ST STE 100",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011263",
            "telephone_number": "303-402-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUITJOHAN",
        "first_name": "JOSHUA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR.0007868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; 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.