Randal Scot Heimark, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH60542762 Issued in WA

Practice address

12140 N Chicken Point Rd
Hayden, ID 83835-6909

Phone

(208) 651-8810

NPI assigned

Aug 27, 2015

Last updated

Aug 27, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1023485901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12140 N CHICKEN POINT RD",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838356909",
            "telephone_number": "208-651-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12140 N CHICKEN POINT RD",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838356909",
            "telephone_number": "208-651-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIMARK",
        "first_name": "RANDAL",
        "middle_name": "SCOT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60542762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.