Active NPI
James Clyde Bosse, O.D.
- Optometrist
- Canon City, CO
National Provider Identifier
1699727032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 894
- Practice address
- 2776 E Main St
Canon City, CO 81212-4010 - Phone
- (719) 275-1523
- NPI assigned
- May 16, 2006
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 894 | CO | Primary |
Addresses
Primary practice location
2776 E Main St
Canon City, CO 81212-4010
Mailing address
29 Eagle Crest Dr
Canon City, CO 81212-9679
Phone (719) 275-3840
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08008948 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 894 | CO | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1699727032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 EAGLE CREST DR",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812129679",
"telephone_number": "719-275-3840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2776 E MAIN ST",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812124010",
"telephone_number": "719-275-1523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSSE",
"first_name": "JAMES",
"middle_name": "CLYDE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CO",
"license": "894",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "08008948",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canon City, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.