Individual provider Active NPI

Tamara Bohren, DC

  • Chiropractor
  • Boulder, CO
National Provider Identifier
1700595055
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
35114 Issued in CA
Practice address
724 Pearl St
Boulder, CO 80302-5006
Phone
(303) 449-3103
Fax
(303) 402-1095
NPI assigned
Nov 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 35114 CA Primary

Addresses

Primary practice location

724 Pearl St
Boulder, CO 80302-5006

Mailing address

1109 8TH St
Coronado, CA 92118-2217
Phone (619) 537-6833

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230724001931 CO Practitioner - Chiropractic 6103286026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Swan Lake Chiropractic HealthGroup PAC ID 7517951395, 2 clinicians

Practice addresses (Care Compare)

724 Pearl St
Boulder, CO 80302-5006
Phone (303) 449-3103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35114CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Swan Lake Chiropractic Health Chiropractor CurrentSince May 28, 2023 Accepting new patients
Goldberg Pawsitive Touch Chiropractic P.C. Chiropractor CurrentSince Jan 29, 2023 Accepting new patients

Locations

1109 8th St
Coronado, CA 92118
Phone (619) 537-6833

724 Pearl St
Boulder, CO 80302
Phone (303) 449-3103

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1700595055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 8TH ST",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921182217",
            "telephone_number": "619-537-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 PEARL ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025006",
            "telephone_number": "303-449-3103",
            "fax_number": "303-402-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHREN",
        "first_name": "TAMARA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-15",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "35114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.