Individual provider Active NPI

Gerard Anthony Bozman, DC

  • Chiropractor
  • Las Vegas, NV
National Provider Identifier
1710186937
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
B01024 Issued in NV
Practice address
8050 Dean Martin
Las Vegas, NV 89139
Phone
(702) 269-1540
Fax
(702) 269-9215
NPI assigned
Jul 17, 2007
Last updated
Jul 17, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X B01024 NV Primary

Addresses

Primary practice location

8050 Dean Martin
Las Vegas, NV 89139

Mailing address

10956 Santorini Dr
Las Vegas, NV 89141
Phone (702) 269-1540

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

LicenseStateTypeSpecialty
B01024NVMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ace Chiropractic Nevada LTD Chiropractor PastSince Mar 23, 2009 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1710186937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10956 SANTORINI DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89141",
            "telephone_number": "702-269-1540",
            "fax_number": "702-269-9215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8050 DEAN MARTIN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89139",
            "telephone_number": "702-269-1540",
            "fax_number": "702-269-9215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZMAN",
        "first_name": "GERARD",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NV",
            "license": "B01024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.