Provider Demographics
NPI:1316025729
Name:BOGAART, ADAM ALEXANDER (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:ALEXANDER
Last Name:BOGAART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 STATE ROAD Z
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PEVELY
Mailing Address - State:MO
Mailing Address - Zip Code:63070-2102
Mailing Address - Country:US
Mailing Address - Phone:636-479-6888
Mailing Address - Fax:636-479-6088
Practice Address - Street 1:1645 STATE ROAD Z
Practice Address - Street 2:SUITE 100
Practice Address - City:PEVELY
Practice Address - State:MO
Practice Address - Zip Code:63070-2102
Practice Address - Country:US
Practice Address - Phone:636-479-6888
Practice Address - Fax:636-479-6088
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004020948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO235360OtherGHP
MO342010901OtherGREAT WEST HEALTHCARE
MO682626OtherHEALTH LINK
MO143663OtherUNITED
MO2233510OtherFIRST HEALTH
MO342010901OtherHUMANA
MO235360OtherCARPENTERS HEALTH AND WEL
MO342010901OtherAETNA
MO342010901OtherCIGNA
MO342010901OtherHEALTH FIRST NETWORK
MO342010901B0GOtherMERCY
MO342010901B0GOtherMERCY
MO257004406Medicare PIN
MO2233510OtherFIRST HEALTH