DR. RANDAL SCOTT BOUCHARD (NPI# 1164595179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164595179 |
Entity Type | Individual |
Full Name | DR. RANDAL SCOTT BOUCHARD |
Credential | D.C. |
Practice Address |
1 Canyon Drive Kayenta AZ 86033-2817 |
Mailing Address |
Po Box 2817 Kayenta AZ 86033-2817 |
Practice Telephone | 9286972547 |
Practice Fax Number | 9286972549 |
Mailing Telephone | 9286972547 |
Mailing Fax Number | 9286972549 |
Enumeration Date | 2006-11-16 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 111N00000X | Chiropractor | 5801 | AZ | Chiropractic Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | ASHN | 1050201 | 01 |
AZ | CCN FIRST HEALTH | 2111887 | 01 |
AZ | HMA | 218760-01 | 01 |
AZ | BCBSAZ | AZ0939060 | 01 |
Street Address |
1 CANYON DRIVE |
City | KAYENTA |
State | AZ |
Zip Code | 86033-2817 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639250137 | Walter F. Robertson | Chiropractor | 1 Canyon Drive, Kayenta, AZ 86033 | 2006-10-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962048306 | Pauletta A Butterfly | Social Worker | Hwy. 160 Mp 394.3, Kayenta, AZ 86033 | 2019-11-20 |
1871143255 | Andrea Dawn Begay | Nurse's Aide | Us Hwy 160 M.p. 394.3, Kayenta, AZ 86033 | 2019-09-17 |
1083264451 | Mavis Ann Bahe | Nurse's Aide | Kayenta Health Center, Us Hwy 160, Mp 394.3, Kayenta, AZ 86033 | 2019-09-17 |
1609420165 | Emily Ingram Nimon | Registered Nurse | Kayenta Health Center Hwy 160 M.p. 394.3, Kayenta, AZ 86033 | 2019-08-01 |
1700439577 | Sherri A Verdon | Registered Nurse | Hwy 160 M.p 394.3, Kayenta, AZ 86033 | 2019-07-22 |
1447712104 | Cynthia Kaye Robbins | Registered Nurse | Us Highway 160 Mile Post 394.3, Kayenta, AZ 86033 | 2019-04-02 |
1871051052 | Brian Jason Miller | Registered Nurse | Hwy 160, Mile Post 394.3, Kayenta, AZ 86033 | 2019-03-07 |
1265915615 | Marissa Brooke Wall | Optometrist | 394.3 Us-160, Kayenta, AZ 86033 | 2018-09-12 |
1467952762 | Michael Ruddy | Pharmacist | Hwy 160 1/2 Mile South of Mile Post 394.3, Kayenta, AZ 86033 | 2018-02-14 |
1922516319 | Xavier Kelton Nelson | Spec/Tech, Pathology | Highway 160 Mp 394.3, Kayenta Health Center, Kayenta, AZ 86033 | 2018-01-19 |
Find all providers in zip 86033 |
Taxonomy Code | 111N00000X |
Grouping | Chiropractic Providers |
Classification | Chiropractor |
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730238221 | Kayenta Family Health Care PC | Chiropractor | One Canyon Drive, Kayenta, AZ 86033-2817 | 2007-01-10 |
1639250137 | Walter F. Robertson | Chiropractor | 1 Canyon Drive, Kayenta, AZ 86033 | 2006-10-18 |
1063470870 | Carol Marie Jaworski | Chiropractor | Kayenta Health Center, Hwy 160 M.p. 394.3, Kayenta, AZ 86033 | 2006-05-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437750528 | Innovative Pain and Wellness Plc | Chiropractor | 8110 W Union Hills Dr Ste 320, Glendale, AZ 85308-8181 | 2020-11-04 |
1881293058 | Modern Chiropractic Company Pllc | Chiropractor | 670 N 54th St Ste 1, Chandler, AZ 85226-1529 | 2020-10-20 |
1487260436 | Chiropure Spine & Injury | Chiropractor | 950 E Baseline Rd Ste 104, Tempe, AZ 85283-1689 | 2020-09-16 |
1396359626 | Adapt Chiropractic Pllc | Chiropractor | 1728 S Greenfield Rd Ste 109, Mesa, AZ 85206-3484 | 2020-09-03 |
1780294835 | Jacquelyn Rose Lewison | Chiropractor | 2055 N Kolb Rd, Tucson, AZ 85715-4099 | 2020-08-04 |
1023628476 | The Wellness Way North Phoenix LLC | Chiropractor | 34406 N 27th Dr Ste 139, Phoenix, AZ 85085-7733 | 2020-07-31 |
1114535366 | Brian Anthony Romero | Chiropractor | 230 S 3rd St Ste B3, Phoenix, AZ 85004-2697 | 2020-07-14 |
1699391052 | Emily Weber | Chiropractor | 3426 E Baseline Rd, Mesa, AZ 85204-7291 | 2020-06-22 |
1841815552 | Madera Chiropractic Pllc | Chiropractor | 560 E Continental Rd Unit 102, Green Valley, AZ 85614-1825 | 2020-06-09 |
1194351379 | Sport and Spine Chiropractic Pllc | Chiropractor | 2155 E University Dr Ste 111, Tempe, AZ 85281-4685 | 2020-03-19 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.