Matthew Brinton Stevens, D.C.
Individual provider Active NPI Chiropractor · Montpelier, ID
NPI 1013027952 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1013027952
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1106 (ID)
- Practice address
- 710 N 4TH St
Montpelier, ID 83254-1050 - Phone
- (208) 847-2273
- Fax
- (208) 847-0678
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1106 | ID | MD | Chiropractor |
| 289810-1202 | UT | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reset P.a. | Chiropractor | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1106 | ID | Yes |
| Chiropractor | 111N00000X | 289810-1202 | UT |
Addresses
Primary practice location
710 N 4TH St
Montpelier, ID 83254-1050
Mailing address
PO Box 26
Montpelier, ID 83254-0026
Phone (208) 847-2273
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010155708 | Other | ID | REGENCY BLUE SHIELD |
| 5638605 | Other | ID | FIRST HEALTH |
| P00271311 | Other | ID | RR MEDICARE |
| C4959 | Other | ID | BLUE CROSS PROVIDER NUMBE |
Other providers in Montpelier, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.