Gary Albert Bohnen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1634 Issued in MN

Practice address

401 East Dual Blvd
Bohnen Chiropractic Center PA
Isanti, MN 55040

Phone

(763) 444-5597

Fax

(763) 444-5598

NPI assigned

Oct 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Bohnen Chiropractic Center P a

  • Chiropractor
  • Isanti, MN
  • NPI 1689721151
  Authorized official Same address or phone

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619050325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "address_2": "BOHNEN CHIROPRACTIC CENTER PA",
            "city": "ISANTI",
            "state": "MN",
            "postal_code": "55040",
            "telephone_number": "763-444-5597",
            "fax_number": "763-444-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 EAST DUAL BLVD",
            "address_2": "BOHNEN CHIROPRACTIC CENTER PA",
            "city": "ISANTI",
            "state": "MN",
            "postal_code": "55040",
            "telephone_number": "763-444-5597",
            "fax_number": "763-444-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHNEN",
        "first_name": "GARY",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROCARE OF MINNESOTA",
            "identifier": "230103",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "56040BO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.