Individual provider Active NPI

John D. Botefuhr, D.C.

  • Rehabilitation Chiropractor
  • Dallas, TX
National Provider Identifier
1609925437
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
DC8668 Issued in TX
Practice address
9041 Garland Rd
Dallas, TX 75218-3919
Phone
(214) 922-8844
Fax
(214) 368-5656
NPI assigned
Jan 10, 2007
Last updated
Feb 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8668 TX
Rehabilitation Chiropractor 111NR0400X DC8668 TX Primary

Addresses

Primary practice location

9041 Garland Rd
Dallas, TX 75218-3919

Mailing address

P.O. Box 601636
Dallas, TX 75360-1636
Phone (214) 922-8844

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170118001857 TX Practitioner - Chiropractic 5294017729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9041 Garland Rd
Dallas, TX 75218-3919
Phone (214) 922-8844

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC8668TXMDRehabilitation Chiropractor

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1609925437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 601636",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753601636",
            "telephone_number": "214-922-8844",
            "fax_number": "214-368-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9041 GARLAND RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183919",
            "telephone_number": "214-922-8844",
            "fax_number": "214-368-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTEFUHR",
        "first_name": "JOHN",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "8668",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "DC8668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.