Active NPI
Ian Joseph Boehm Jr., DC
- Chiropractor
- Lynn, MA
National Provider Identifier
1467405134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1269
- Practice address
- 9 Boston St Ste 1
Lynn, MA 01904-2536 - Phone
- (781) 599-3631
- Fax
- (781) 599-2285
- NPI assigned
- May 17, 2006
- Last updated
- Aug 28, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1269 | MA | Primary |
Addresses
Primary practice location
9 Boston St Ste 1
Lynn, MA 01904-2536
Mailing address
9 Boston St Ste 1
Lynn, MA 01904-2536
Phone (781) 599-3631
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110030160A | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
271 Western Ave
Suite 102
Lynn, MA 01904-3000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1269 | MA | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Everett Chiropractic LLC | Chiropractor | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Everett, MA
- NPI 1295432037
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598572800000",
"number": "1467405134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9 BOSTON ST STE 1",
"city": "LYNN",
"state": "MA",
"postal_code": "019042536",
"telephone_number": "781-599-3631",
"fax_number": "781-599-2285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 BOSTON ST STE 1",
"city": "LYNN",
"state": "MA",
"postal_code": "019042536",
"telephone_number": "781-599-3631",
"fax_number": "781-599-2285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOEHM",
"first_name": "IAN",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2020-08-28",
"certification_date": "2020-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "1269",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110030160A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.