Vital Performance LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2017015434 Issued in MO

Legal business name

VITAL PERFORMANCE LLC

Doing business as

Vital Performance Chiropractic

Practice address

7827 Highway N Ste 102
Dardenne Prairie, MO 63368-7199

Phone

(636) 486-6933

NPI assigned

Sep 19, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Dustin Charles Jerome Bosson, DC

Title

Doctor/Owner

Phone

(636) 486-6933

Specialties & licenses 1

Addresses

Other names 1

• Vital Performance Chiropractic Doing business as

Locations

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505779200000",
    "number": "1619496957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7827 HIGHWAY N",
            "address_2": "#102",
            "city": "DARDENNE PRAIRIE",
            "state": "MO",
            "postal_code": "63368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7827 HIGHWAY N STE 102",
            "city": "DARDENNE PRAIRIE",
            "state": "MO",
            "postal_code": "633687199",
            "telephone_number": "636-486-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-19",
        "last_updated": "2017-09-19",
        "status": "A",
        "authorized_official_last_name": "BOSSON",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "CHARLES JEROME",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "636-486-6933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2017015434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vital Performance Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Dardenne Prairie, MO
• Providers in Dardenne Prairie, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; 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.