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Deactivated NPI 1477579928 Deactivated / Inactive NPI Male Practitioner

Dr. Edward John Bouldin , DC

Chiropractor • Irwin, PA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Edward Bouldin has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 15, 2006
NPI Deactivation Date September 18, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Edward Bouldin, DC was a registered Chiropractor practicing in Irwin, PA. Throughout an active medical career spanning 19 years, Dr. Bouldin provided care at the practice location at 421 MAIN ST until profile deactivation on 2025-09-18.

Practice Location & Contact Primary Location

Practice Address

421 Main St

Irwin, PA 156423411

Telephone 7248647255
Fax 7248647564

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in Irwin, PA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 24.6 Yrs
State Avg: 26.1 Yrs
Regional Practice Density
14 Specialists

Practicing in Irwin, PA (4175 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License PA DC002004L

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.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated September 18, 2025

Record deactivated on September 18, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 421 MAIN ST, IRWIN, PA 156423411 (Tel: 7248647255)

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Updated Business Mailing Address July 08, 2007

Registered at 1001 ASH ST, IRWIN, PA 156423837 (Tel: 7248647255)

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Provider Name / Credentials Updated July 08, 2007

Recorded as EDWARD BOULDIN, DC

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Chiropractor (License #DC002004L in PA)

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Initial NPI Registration & Enumeration July 15, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1477579928
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 15, 2006
Last Update: July 08, 2007
Deactivation Date: September 18, 2025

Mailing Address

1001 Ash St

Irwin, PA 156423837

Phone: 7248647255

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.