Organization Active NPI

Dr Bryan Boerjan Chiropractic PLLC

  • Chiropractor
  • Pensacola, FL
National Provider Identifier
1780403279
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DR BRYAN BOERJAN CHIROPRACTIC PLLC
Practice address
1101 N 9TH Ave
Pensacola, FL 32501-3235
Phone
(850) 738-1515
NPI assigned
Oct 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Authorized official

Name
Dr. Bryan Boerjan, DCNPI 1194951046
Title
Owner
Phone
(205) 821-8347

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

1101 N 9TH Ave
Pensacola, FL 32501-3235

Mailing address

1101 N 9TH Ave
Pensacola, FL 32501-3235
Phone (850) 738-1515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241205004395 FL Part B Supplier - Clinic/Group Practice 0446786065 Receives reassigned benefits from 1 practitioner
Practice locations: Pensacola, FL

National Provider Directory

National Provider Directory

Locations

1101 N 9th Ave
Pensacola, FL 32501
Phone (850) 738-1515

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1780403279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013235",
            "telephone_number": "850-738-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013235",
            "telephone_number": "850-738-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR BRYAN BOERJAN CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "BOERJAN",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-821-8347",
        "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": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.