Kevin Boots, DC
Individual provider Active NPI Chiropractor · Kimberly, WI
NPI 1629665443 · NPPES record last updated Dec 28, 2020
Key facts
- NPI
- 1629665443
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5592-12 (WI)
- Practice address
- 1020 Truman St Ste B
Kimberly, WI 54136-2215 - Phone
- (920) 997-9700
- Fax
- (920) 997-0060
- NPI assigned
- Dec 28, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Boots Chiropractic and Wellness Center, S.C.
Practice addresses (Care Compare)
1020 Truman St
Suite B
Kimberly, WI 54136-2215
Phone (920) 997-9700
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210120002492 | WI | Practitioner - Chiropractic | 4981018603 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5592-12 | WI | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5592-12 | WI | Yes |
Addresses
Primary practice location
1020 Truman St Ste B
Kimberly, WI 54136-2215
Mailing address
1020 Truman St Ste B
Kimberly, WI 54136-2215
Phone (920) 997-9700
Other providers in Kimberly, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.