NPIMap

Organization Active NPI

Boots Chiropractic and Wellness Center, S.C.

  • Chiropractor
  • Kimberly, WI
National Provider Identifier
1659420537
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2055-012 Issued in WI
Legal business name
BOOTS CHIROPRACTIC AND WELLNESS CENTER, S.C.
Practice address
1020 Truman St Ste B
Kimberly, WI 54136-2211
Phone
(920) 997-9700
Fax
(920) 997-0060
NPI assigned
Jan 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. James Robert Boots, DCNPI 1356417067
Title
Owner Chiropractor
Phone
(920) 997-9700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2055-012 WI Primary

Addresses

Primary practice location

1020 Truman St Ste B
Kimberly, WI 54136-2211

Mailing address

1020 Truman St Ste B
Kimberly, WI 54136-2211
Phone (920) 997-9700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100818000217 WI Part B Supplier - Clinic/Group Practice 8224162888 Receives reassigned benefits from 4 practitioners
Practice locations: Kimberly, WI

National Provider Directory

National Provider Directory

Locations

1020 Truman St
Ste B
Kimberly, WI 54136
Phone (920) 997-9700

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659420537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 TRUMAN ST STE B",
            "city": "KIMBERLY",
            "state": "WI",
            "postal_code": "541362211",
            "telephone_number": "920-997-9700",
            "fax_number": "920-997-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 TRUMAN ST STE B",
            "city": "KIMBERLY",
            "state": "WI",
            "postal_code": "541362211",
            "telephone_number": "920-997-9700",
            "fax_number": "920-997-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOTS CHIROPRACTIC AND WELLNESS CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOOTS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER CHIROPRACTOR",
        "authorized_official_telephone_number": "920-997-9700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2055-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kimberly, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.