EMBODY BOSS LLC (NPI# 1316473325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316473325 |
| Entity Type | Organization |
| Organization Name | EMBODY BOSS LLC |
| Other Organization Name | EMBODY BOSS MANUAL THERAPEUTICS & PREVENTATIVE HEALTH PRACTICE |
| Practice Address |
128 E 6th St Bloomington IN 47408-3311 |
| Practice Telephone | 8125837891 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |
| Authorized Official Name | DR. CHANELLE JANETTE NORMAN (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 8125837891 |
| Authorized Official Credential | PT, DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
IN | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| emBODY BOSS Manual Therapeutics & Preventative Health Practice | Doing Business As Name - Organization |
| Street Address |
128 E 6TH ST |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47408-3311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669079398 | Ta-kisha Jones | Health Educator | 309 N. Woodlawn Ave, Bloomington, IN 47408 | 2020-10-06 |
| 1265915904 | Meghan Elizabeth Kinkead | Specialist/Technologist | Simon Skjodt Assembly Hall, 1001 East 17th Street, Bloomington, IN 47408 | 2018-09-10 |
| 1316499395 | Marabai Rose Counseling, LLC | Social Worker | 4568 East State Rd 45, Bloomington, IN 47408 | 2016-10-26 |
| 1295133908 | Eden Embree | Specialist/Technologist | 1001 E. 17th Street, Assembly Hall, Bloomington, IN 47408 | 2014-12-11 |
| 1588995229 | Create-a-smile PC | Dentist | 219 E. 17th St., Bloomington, IN 47408 | 2010-01-20 |
| 1609053289 | Laurette Frazier | Counselor | 2815 E. 10th Street, Stone Belt, Bloomington, IN 47408 | 2008-01-26 |
| 1770709917 | Robin A. Roberts | Dentist | 104 E. 19th Street, Bloomington, IN 47408 | 2007-04-17 |
| 1376614008 | David Rudolf Fletcher | General Practice | 126 S. Hampton Ct, Bloomington, IN 47408 | 2006-11-13 |
| 1114013752 | Christole, Inc | Intermediate Care Facility, Mentally Retarded | 2727 N Dunn, Bloomington, IN 47408 | 2006-10-04 |
| 1003850322 | Priti V Jindal | Internal Medicine | 2455 N Tamarack Trl, Bloomington, IN 47408 | 2006-06-16 |
| Find all providers in zip 47408 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962987255 | Ptworx LLC | Clinic/Center | 5006 S Rogers St, Bloomington, IN 47403-4655 | 2018-10-02 |
| 1013030352 | Physiotherapy Associates Inc | Clinic/Center | 1355 W Bloomfield Rd Ste B, Bloomington, IN 47403-2052 | 2007-04-10 |
| 1518049337 | Illinois Physical Therapy Associates Limited Partnership | Clinic/Center | 3609 General Electric Rd, Suite B, Bloomington, IL 61704-8534 | 2006-10-20 |
| 1720549892 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 2455 N Tamarack Trl, Bloomington, IN 47408-1294 | 2019-03-29 |
| 1487164869 | Vitalrehab Physical Therapy, LLC | Clinic/Center | 1015 S Mercer Ave, Bloomington, IL 61701-7107 | 2017-10-11 |
| 1639565971 | Champion Fitness, Inc | Clinic/Center | 1015 S Mercer Ave, Bloomington, IL 61701-7107 | 2015-04-14 |
| 1700279007 | Delong Wellness, LLC | Clinic/Center | 218 N Rogers St, Bloomington, IN 47404-3969 | 2015-03-11 |
| 1104236165 | Heritage Enterprises, Inc | Clinic/Center | 700 E Walnut St, Bloomington, IL 61701-3244 | 2014-04-30 |
| 1861810228 | Rally Physical Therapy LLC | Clinic/Center | 19165 Meander Way, Bloomington, IL 61705-5227 | 2014-04-02 |
| 1134437460 | Institute for Athletic Medicine | Clinic/Center | 600 W 98th St, Bloomington, MN 55420-4773 | 2010-09-21 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 47408 |
Please comment or provide details below to improve the information on EMBODY BOSS LLC.
| 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.