Bosma Chiropractic L.L.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3807-012 Issued in WI

Legal business name

BOSMA CHIROPRACTIC L.L.C.

Practice address

450 High St.
Ste 4
Wrightstown, WI 54180

Phone

(920) 532-6450

Fax

(920) 532-6455

NPI assigned

Apr 23, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bradley Richard Bosma, D.C.NPI 1366449696

Title

Owner

Phone

(920) 532-6450

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

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.

• Bradley Richard Bosma, D.C.

  • Chiropractor
  • Wrightstown, WI
  • NPI 1366449696
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790903110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 HIGH ST.",
            "address_2": "STE 4",
            "city": "WRIGHTSTOWN",
            "state": "WI",
            "postal_code": "54180",
            "telephone_number": "920-532-6450",
            "fax_number": "920-532-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 HIGH ST.",
            "address_2": "STE 4",
            "city": "WRIGHTSTOWN",
            "state": "WI",
            "postal_code": "54180",
            "telephone_number": "920-532-6450",
            "fax_number": "920-532-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSMA CHIROPRACTIC L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOSMA",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-532-6450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3807-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "389-36600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bel-Regional Home Medical Inc (Bellin Health Pharmacy - Wrightstown)
• Bel-Regional Home Medical Inc
• Bellin Memorial Hospital Inc (FMC Wrightstown)
• Dulcie R Bosi, RN
• Bradley Richard Bosma, D.C.
• Jordan E Burton
• Ashley E. Callaway, PA
• Dawn Craft, D.C.
• D&D Chiropractic and Wellness, LLC (D&D Chiropractic and Wellness)

• Chiropractor in Wrightstown, WI
• Providers in Wrightstown, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.