Individual provider Active NPI

Willem E. Bos, D.C.

  • Chiropractor
  • Chandler, AZ
National Provider Identifier
1821299215
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
07667595 Issued in AZ
Practice address
200 N Chippewa PL
Chandler, AZ 85224-4307
Phone
(480) 732-1000
Fax
(480) 732-1202
NPI assigned
May 31, 2007
Last updated
May 15, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 07667595 AZ Primary

Addresses

Primary practice location

200 N Chippewa PL
Chandler, AZ 85224-4307

Mailing address

200 N Chippewa PL
Chandler, AZ 85224-4307
Phone (480) 732-1000

Other identifiers 1

IdentifierTypeStateIssuer
AZ0939730OtherBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050531000260 AZ Practitioner - Chiropractic 8921082280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 N Chippewa PL
Chandler, AZ 85224-4307
Phone (480) 732-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07667595AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity Chiropractic PC Chiropractor Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1821299215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N CHIPPEWA PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244307",
            "telephone_number": "480-732-1000",
            "fax_number": "480-732-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N CHIPPEWA PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852244307",
            "telephone_number": "480-732-1000",
            "fax_number": "480-732-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOS",
        "first_name": "WILLEM",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "07667595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0939730",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.