Organization Active NPI

Boerm Family Chiropractic PLLC

Doing business as Boerm Family Chiropractic

  • Chiropractor
  • Grundy Center, IA
National Provider Identifier
1760262158
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BOERM FAMILY CHIROPRACTIC PLLC
Doing business as
Boerm Family Chiropractic
Practice address
412 G Ave
Grundy Center, IA 50638-1747
Phone
(319) 824-3650
NPI assigned
Oct 3, 2023
Last updated
Dec 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Authorized official

Name
Dr. Mitchell L Boerm, DCNPI 1164023735
Title
Owner
Phone
(641) 691-3489

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

412 G Ave
Grundy Center, IA 50638-1747

Mailing address

412 G Ave
Grundy Center, IA 50638-1747
Phone (319) 824-3650

Other names 1

  • Boerm Family Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240308000808 IA Part B Supplier - Clinic/Group Practice 2567808827 Receives reassigned benefits from 2 practitioners
Practice locations: Grundy Center, IA

National Provider Directory

National Provider Directory

Locations

412 G Ave
Grundy Center, IA 50638
Phone (319) 824-3650

Practitioners & affiliated clinicians

Practitioners 3

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": "1696291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1760262158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 G AVE",
            "city": "GRUNDY CENTER",
            "state": "IA",
            "postal_code": "506381747",
            "telephone_number": "319-824-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 G AVE",
            "city": "GRUNDY CENTER",
            "state": "IA",
            "postal_code": "506381747",
            "telephone_number": "319-824-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOERM FAMILY CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-03",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "BOERM",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "641-691-3489",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boerm Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grundy Center, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.