IDAHO SPINE AND SPORTS CHIROPRACTIC INC (NPI# 1427242734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427242734 |
| Entity Type | Organization |
| Organization Name | IDAHO SPINE AND SPORTS CHIROPRACTIC INC |
| Practice Address |
2399 S Orchard St Ste. 204 Boise ID 83705-3793 |
| Practice Telephone | 2083232833 |
| Practice Fax Number | 2083232834 |
| Mailing Telephone | 2083232833 |
| Mailing Fax Number | 2083232834 |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2015-01-28 |
| Authorized Official Name | DR. KENDRICK L TWEEDT (OWNER) |
| Authorized Official Telephone | 2083232833 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Street Address |
2399 S ORCHARD ST STE. 204 |
| City | BOISE |
| State | ID |
| Zip Code | 83705-3793 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588634356 | Portable Xray of Idaho LLC | Clinic/Center | 2399 S Orchard St, Boise, ID 83705-3793 | 2006-01-25 |
| 1275984098 | All-city Transpprt | Non-emergency Medical Transport (VAN) | 2399 S Orchard St, #213, Boise, ID 83705-3793 | 2016-06-22 |
| 1679958896 | Schryver Medical Sales and Marketing, LLC | Physiological Laboratory | 2399 S Orchard St, Suite 105, Boise, ID 83705-3793 | 2015-07-29 |
| 1144607359 | Michelle Alden | Counselor | 2399 S Orchard St, Suite 201, Boise, ID 83705-3793 | 2015-04-27 |
| 1770898165 | Erin A Garrison | Counselor | 2399 S Orchard St, Suite 203, Boise, ID 83705-3793 | 2010-08-10 |
| 1497078935 | Denae Barowsky | Counselor | 2399 S Orchard St, Suite 203, Boise, ID 83705-3793 | 2010-03-11 |
| 1679801831 | Helen Ahern | Radiologic Technologist | 2399 S Orchard St, Suite 202a, Boise, ID 83705-3793 | 2009-11-30 |
| 1801025739 | Stephanie Donaldson | Counselor | 2399 S Orchard St, Suite 203, Boise, ID 83705-3793 | 2009-07-13 |
| 1104082221 | Schryver Medical Sales and Marketing, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2399 S Orchard St, 105, Boise, ID 83705-3793 | 2008-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938779 | Halo Health Services LLC | Community/Behavioral Health | 1111 S Orchard St, Boise, Id 83705, Boise, ID 83705 | 2020-06-29 |
| 1598265860 | Felica Jo Duce | Counselor | 921 S Orchard St Ste 103, Boise, ID 83705 | 2018-02-13 |
| 1215364278 | Erica Zelickowski | Pharmacist | 1653 S Vista Avenue, Boise, ID 83705 | 2013-10-04 |
| 1952655490 | Aida Dizdar-barac | Social Worker | 2273 S. Vista Avenue, Suite 190, Boise, ID 83705 | 2012-11-06 |
| 1033461033 | Julie Marie Meek | Social Worker | 3324 W Elder St, Boise, ID 83705 | 2012-10-15 |
| 1568761112 | Berkeley Fraser | Pharmacist | 3527 S Federal Way Suite 104, Boise, ID 83705 | 2011-03-22 |
| 1922311042 | Amber Vania | Family Medicine | 4971 W. Overland Road, Boise, ID 83705 | 2010-07-18 |
| 1295056836 | Cherise M Wetzel | Social Worker | 1625 S Eagleson Rd, B1, Boise, ID 83705 | 2010-06-17 |
| 1558685305 | Rae Ann Norell | Social Worker | 2273 S. Vista Ave, #190 Treasure Valley Community Counseling Services, Boise, ID 83705 | 2010-03-23 |
| 1164679932 | Oreana Harless | Social Worker | 2550 South Vista Ave, Boise, ID 83705 | 2008-08-25 |
| Find all providers in zip 83705 | ||||
| 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 |
|---|---|---|---|---|
| 1124638143 | Madison J Wills | Chiropractor | 9196 W Emerald St Ste 120, Boise, ID 83704-8003 | 2020-08-04 |
| 1962027433 | Convergence Chiropractic Company | Chiropractor | 404 E Parkcenter Blvd Ste 170, Boise, ID 83706-7564 | 2020-06-10 |
| 1356992788 | John Robert Bynum | Chiropractor | 6013 W Overland Rd Ste 101, Boise, ID 83709-3078 | 2019-09-26 |
| 1386203974 | Dylan Roy | Chiropractor | 5632 W State Street, Boise, ID 83703 | 2019-06-07 |
| 1780150292 | Nicolas Asla | Chiropractor | 403 S 11th St Ste 110, Boise, ID 83702-6968 | 2018-10-23 |
| 1386110385 | Chase Dudley | Chiropractor | 503 N 27th St, Boise, ID 83702-4704 | 2018-10-17 |
| 1730663634 | Ty Rodriguez | Chiropractor | 9328 W Overland Rd, Boise, ID 83709-2505 | 2018-09-18 |
| 1083128151 | Rebecca L Jergenson | Chiropractor | 2300 S Orchard St Ste A, Boise, ID 83705-6723 | 2017-11-27 |
| 1558809558 | Dixon Mooseau | Chiropractor | 1390 S Maple Grove Rd Ste 200, Boise, ID 83709-1610 | 2017-02-09 |
| 1790237956 | Oscar Terrazas Jr. | Chiropractor | 5244 W Overland Rd, Boise, ID 83705-2636 | 2016-11-03 |
| Find all providers in BOISE | ||||
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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.