Individual provider Active NPI

Fredric Charles Hill I, D.C.

  • Chiropractor
  • Blackfoot, ID
National Provider Identifier
1003982471
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-535 Issued in ID
Practice address
195 Elm St
Blackfoot, ID 83221-1970
Phone
(208) 785-5262
Fax
(208) 785-5263
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-535 ID Primary

Addresses

Primary practice location

195 Elm St
Blackfoot, ID 83221-1970

Mailing address

195 Elm St
Blackfoot, ID 83221-1970
Phone (208) 785-5262

Other identifiers 1

IdentifierTypeStateIssuer
CHIA-535OtherIDSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003982471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 ELM ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211970",
            "telephone_number": "208-785-5262",
            "fax_number": "208-785-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 ELM ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211970",
            "telephone_number": "208-785-5262",
            "fax_number": "208-785-5263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "FREDRIC",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CHIA-535",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackfoot, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.