Nicholas John Boris, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

16239 Issued in AR

Practice address

2900 Medical Center Pkwy Ste 110
Bentonville, AR 72712-3212

Phone

(479) 715-4262

NPI assigned

Nov 19, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1770129314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 MEDICAL CENTER PKWY STE 110",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123212",
            "telephone_number": "479-715-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 MEDICAL CENTER PKWY STE 110",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123212",
            "telephone_number": "479-715-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORIS",
        "first_name": "NICHOLAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-19",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "16239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Karina Bonilla, COTA/L
• Brenda Angelica Bonilla
• Megan Bonilla, PT, DPT
• Allauna Marie Boone, COTA/L
• Bill Booth
• Erica Mary Boughfman, LPC
• Catherine Ann Bourgeois, DR
• Danielle Bowlby
• Amber Presley Boyd, LPC
• Ramon Boykins

• Chiropractor in Bentonville, AR
• Providers in Bentonville, AR by specialty
• Chiropractor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.