Boothe Chiropractic Clinic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104556300 Issued in VA

Legal business name

BOOTHE CHIROPRACTIC CLINIC

Practice address

642 North Main St
Marion, VA 24354

Phone

(276) 783-7005

Fax

(276) 783-8080

NPI assigned

Apr 10, 2006

Last updated

Nov 14, 2007By 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

Mr. Samuel Kenneth Boothe, DCNPI 1689601569

Title

Vice President

Phone

(276) 783-7005

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 6

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.

• Robert Allen Boothe II, DC

  • Chiropractor
  • Abingdon, VA
  • NPI 1851309363
  Medicare reassignment NPD
• Samuel Kenneth Boothe, DC

  • Chiropractor
  • Marion, VA
  • NPI 1689601569
  NPD (past) Authorized official
• Gabriel Boothe, DC

  • Chiropractor
  • Abingdon, VA
  • NPI 1114862299
  NPD
• Andrew James Farris, D.C.

  • Chiropractor
  • Abingdon, VA
  • NPI 1992718548
  NPD (past)
• Matthew Benson Eugene Jessee, D.C.

  • Chiropractor
  • Wise, VA
  • NPI 1851467328
  NPD (past)
• Russell Arville Justus, D.C.

  • Chiropractor
  • Morristown, TN
  • NPI 1376577783
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1962465187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 NORTH MAIN ST",
            "city": "MARION",
            "state": "VA",
            "postal_code": "24354",
            "telephone_number": "276-783-7005",
            "fax_number": "276-783-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 NORTH MAIN ST",
            "city": "MARION",
            "state": "VA",
            "postal_code": "24354",
            "telephone_number": "276-783-7005",
            "fax_number": "276-783-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOTHE CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "BOOTHE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "276-783-7005",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104555931",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001760",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104556300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Amy Rachelle Blue, O.D.
• Emily Jane Bodfish
• David R Boehm, LCSW
• Kellie Bonsor, APRN, FNP-BC
• Boothe Chirpractic Center, LLC
• Samuel Kenneth Boothe, DC
• Karen Lynn Bordwine, FNP-BC
• Elizabeth A. Bradshaw, MS
• Emily Gatewood Buchanan Bralley, D.O.

• Chiropractor in Marion, VA
• Providers in Marion, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.