JOHN DAVID BOOMAN (NPI# 1336272392) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336272392 |
| Entity Type | Individual |
| Full Name | JOHN DAVID BOOMAN |
| Credential | D.O. |
| Practice Address |
102 1st St Se Spring Grove MN 55974 |
| Mailing Address |
13006 W Beaver Rd Spring Grove MN 55974-2463 |
| Practice Telephone | 5074985445 |
| Practice Fax Number | 5074983577 |
| Mailing Telephone | 5074985445 |
| Mailing Fax Number | 5074983577 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2367 | MN | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBS PROVIDER NUMBER | 06952BO | 01 |
| MN | CHIRO CARE OF MN PROV NO. | 231665 | 01 |
| Street Address |
102 1ST ST SE |
| City | SPRING GROVE |
| State | MN |
| Zip Code | 55974 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306084314 | Spring Grove Family Chiropractic, Pa | Chiropractor | 102 1st St Se, Spring Grove, MN 55974 | 2009-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881764041 | Spring Grove Ambulance Service | Ambulance | 192 West Main St, Spring Grove, MN 55974 | 2006-11-08 |
| 1649366485 | Booman Chiropractic Corporation | Chiropractor | 102 1st Street Se, Spring Grove, MN 55974 | 2006-10-05 |
| 1700940921 | Independent School District #297 | Local Education Agency (LEA) | 113 2nd Ave Nw, Spring Grove, MN 55974-1204 | 2006-12-21 |
| 1306920491 | Rushford Drug Company | Pharmacy | 137 W Main St, Spring Grove, MN 55974-1225 | 2006-10-25 |
| 1962019364 | Astrup Drug Inc | Pharmacy | 137 W Main St, Spring Grove, MN 55974-1225 | 2020-09-29 |
| 1801431549 | Amanda Rae Schuttemeier | Pharmacist | 137 W Main St, Spring Grove, MN 55974-1225 | 2019-11-15 |
| 1316206709 | Astrup Drug Inc | Pharmacy | 137 W Main St, Spring Grove, MN 55974-1225 | 2012-05-07 |
| 1053355016 | Shawn Ken Bloyer | Specialist/Technologist | 161 1st St Sw, Spring Grove, MN 55974-1270 | 2006-06-16 |
| 1215931696 | Gregory N Tjossem | Family Medicine | 123 5th Ave Se, Spring Grove, MN 55974-1318 | 2005-06-13 |
| 1548263122 | Glenn P Mccarty | Family Medicine | 125 5th Ave Se, Spring Grove, MN 55974-1318 | 2005-05-27 |
| Find all providers in zip 55974 | ||||
| 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 |
|---|---|---|---|---|
| 1134402977 | Yuka Ryan | Chiropractor | 4005 May Ln, Spring Grove, IL 60081-8615 | 2011-09-27 |
| 1477741262 | Michael Eric Udo | Chiropractor | 515 Lakeview Dr, Spring Grove, PA 17362-8449 | 2007-10-05 |
| 1740332592 | Spring Grove Medical Offices Ltd | Chiropractor | 2100 Route 12, Suite 101, Spring Grove, IL 60081 | 2007-01-18 |
| 1649366485 | Booman Chiropractic Corporation | Chiropractor | 102 1st Street Se, Spring Grove, MN 55974 | 2006-10-05 |
| 1013025824 | Darrin R Foszcz | Chiropractor | 2207 N Us Highway 12, Suite E, Spring Grove, IL 60081-9706 | 2006-08-29 |
| 1053429670 | Ralph Destephano | Chiropractor | 2100 N Us Hwy 12, Suite 101, Spring Grove, IL 60081 | 2006-08-25 |
| 1932214665 | Sonia Kwapisinski | Chiropractor | 2900 N Us Highway 12, Suite J, Spring Grove, IL 60081-8322 | 2006-08-21 |
| 1245256338 | Natalie J Frobish | Chiropractor | 2900 N. Us Highway 12, Suite J, Spring Grove, IL 60081-8322 | 2006-07-14 |
| 1306084314 | Spring Grove Family Chiropractic, Pa | Chiropractor | 102 1st St Se, Spring Grove, MN 55974 | 2009-01-29 |
| 1164647442 | Discover Chiropractic Health Center Ltd | Chiropractor | 2207 N Us Highway 12, Suite E, Spring Grove, IL 60081-9706 | 2007-04-13 |
| Find all providers in SPRING GROVE | ||||
| City | SPRING GROVE |
| Zip Code | 55974 |
Please comment or provide details below to improve the information on JOHN DAVID BOOMAN.
| 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.