Jacalyn Renae Amrine, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1930 Issued in ID

Practice address

435 E Shore Dr Ste 130
Eagle, ID 83616-5754

Phone

(208) 917-1929

Fax

(208) 485-9629

NPI assigned

Dec 17, 2011

Last updated

Jan 20, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Jacalyn Renae Marossy Former name

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1324080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1003185265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 E SHORE DR STE 130",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165754",
            "telephone_number": "208-917-1929",
            "fax_number": "208-485-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 E SHORE DR STE 130",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165754",
            "telephone_number": "208-917-1929",
            "fax_number": "208-485-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMRINE",
        "first_name": "JACALYN",
        "middle_name": "RENAE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-17",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "32089",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACALYN",
            "last_name": "MAROSSY",
            "middle_name": "RENAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Chiropractor in Eagle, ID
• Providers in Eagle, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.