Jessica Mae Boyles, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6377 Issued in MN

Practice address

7301 Ohms LN Ste 430
Edina, MN 55439-2376

Phone

(612) 564-0403

NPI assigned

Jun 1, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Eagle Creek Chiropractic

  • Physical Therapist
  • Prior Lake, MN
  • NPI 1073847554
  NPD (past)

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1780112847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15512 RIDGEMONT AVE SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553721840",
            "telephone_number": "952-201-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 OHMS LN STE 430",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392376",
            "telephone_number": "612-564-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLES",
        "first_name": "JESSICA",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikita Boyd, CNP
• Amy Michelle Boyden-Hoekstra, P.T.
• Margaret Boyer, PHD, LP
• Amy Boyle, RDN
• Joseph Gregory Boyle, LICSW, CEAP, SAP
• Jess Boysen, M.D.
• Matthew Robert Braasch, M.D.
• Michael Braaton, MD
• Gordon A Braatz, PH.D.
• Timothy P. Braatz, M.D.

• Chiropractor in Edina, MN
• Providers in Edina, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.