Charles Green Chiropractor

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

C-534 Issued in ID

Legal business name

CHARLES GREEN CHIROPRACTOR

Practice address

7683 W Riverside Dr
Boise, ID 83714-6188

Phone

(208) 429-8085

NPI assigned

Mar 13, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Charles William Green, D.C.

Title

President

Phone

(208) 429-8085

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1043481351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7683 W RIVERSIDE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837146188",
            "telephone_number": "208-429-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7683 W RIVERSIDE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837146188",
            "telephone_number": "208-429-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES GREEN CHIROPRACTOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-429-8085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "C-534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Boise, ID
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.