Lisa Lynn Boeser, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4325 Issued in MN

Practice address

201 W Burnsville Pkwy
158
Burnsville, MN 55337-2527

Phone

(952) 224-9466

Fax

(952) 224-9466

NPI assigned

Mar 27, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Skyline Chiropractic, P.a.

  • Chiropractor
  • Burnsville, MN
  • NPI 1841366085
  NPD (past)

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1447378146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W BURNSVILLE PKWY",
            "address_2": "158",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372527",
            "telephone_number": "952-224-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W BURNSVILLE PKWY",
            "address_2": "158",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372527",
            "telephone_number": "952-224-9466",
            "fax_number": "952-224-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOESER",
        "first_name": "LISA",
        "middle_name": "LYNN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN-ITS PROVIDER NUMBER",
            "identifier": "690923000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bloom Studio and Counseling Services LLC
• Jody Lee Bloom
• Kathleen Ann Bloom, D.C.
• Jerry Blume, LICSW
• Sienna Alice Boeckman
• Mary Boevers
• Alecia Bohnsack
• Jamieya Z Bolin-Johnson, BEHAVIORAL THERAPIST
• Roberta Amber Bolitho, CST
• Katenka Elaine Bollenbeck

• Chiropractor in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.