NPIMap

Organization Active NPI

Price Chiropractic Center Chartered

  • Orthopedic Chiropractor
  • Boise, ID
National Provider Identifier
1063826535
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
CHIA-452 Issued in ID
Legal business name
PRICE CHIROPRACTIC CENTER CHARTERED
Practice address
9508 W Fairview Ave
Boise, ID 83704-8103
Phone
(208) 323-1313
Fax
(208) 323-1368
NPI assigned
Jun 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Authorized official

Name
Tyler Reidhead, D.C.NPI 1750830345
Title
Owner
Phone
(208) 323-1313

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NX0800X CHIA-452 ID Primary

Addresses

Primary practice location

9508 W Fairview Ave
Boise, ID 83704-8103

Mailing address

9508 W Fairview Ave
Boise, ID 83704-8103
Phone (208) 323-1313

Other identifiers 1

IdentifierTypeStateIssuer
CHIA-452OtherIDCHIROPRACTIC LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190710001388 ID Part B Supplier - Clinic/Group Practice 2466719513 Receives reassigned benefits from 3 practitioners
Practice locations: Boise, ID

National Provider Directory

National Provider Directory

Locations

9508 W Fairview Ave
Boise, ID 83704
Phone (208) 323-1313

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750377600000",
    "number": "1063826535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9508 W FAIRVIEW AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048103",
            "telephone_number": "208-323-1313",
            "fax_number": "208-323-1368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9508 W FAIRVIEW AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048103",
            "telephone_number": "208-323-1313",
            "fax_number": "208-323-1368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRICE CHIROPRACTIC CENTER CHARTERED",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-12",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A",
        "authorized_official_last_name": "REIDHEAD",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-323-1313",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": "ID",
            "license": "CHIA-452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE",
            "identifier": "CHIA-452",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.

Verify at the official NPI Registry.