Active NPI
Shawn A Rudkin, DC CCEP
- Chiropractor
- Parma, ID
National Provider Identifier
1063587194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIA857
- Practice address
- 101 E Grove Avenue
Parma, ID 83660-0154 - Phone
- (208) 722-9999
- NPI assigned
- Nov 22, 2006
- Last updated
- May 13, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIA857 | ID | Primary |
Addresses
Primary practice location
101 E Grove Avenue
Parma, ID 83660-0154
Mailing address
PO Box 154
Parma, ID 83660-0154
Phone (208) 722-9999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA857 | ID | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Idaho Spine and Sports Chiropractic Inc | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Chiropractor
- Boise, ID
- NPI 1427242734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210636800000",
"number": "1063587194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 154",
"city": "PARMA",
"state": "ID",
"postal_code": "836600154",
"telephone_number": "208-722-9999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 E GROVE AVENUE",
"city": "PARMA",
"state": "ID",
"postal_code": "836600154",
"telephone_number": "208-722-9999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDKIN",
"first_name": "SHAWN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DC CCEP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-22",
"last_updated": "2008-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ID",
"license": "CHIA857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Parma, ID
- Ryan Michael Leininger, DMD
- MD Medical Management Inc
- Parma Physical Therapy LLC
- Parma Rural Fire Protection District (Parma Ambulance Service)
- Kaleigh Yvonne Perry, CPM, LM
- Darby Shadwick
- Shawn a Rudkin & Associates P C (Parma Chiropractic)
- Allan Walker Stevenson, DDS
- Trone Health Services Inc (Medicap Pharmacy 8391)
- Trone Health Services Inc (Medicap Pharmacy 8391)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.