Christopher C Peine, D.O.

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

O-0366 Issued in ID

Practice address

507 S Fitness PL
Ste 110
Eagle, ID 83616-6552

Phone

(208) 947-0926

Fax

(831) 636-6108

NPI assigned

Jul 31, 2006

Last updated

Apr 14, 2016By 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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2019 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Peine Osteopathic Medicine PLLC

  • Family Medicine Physician
  • Eagle, ID
  • NPI 1306010046
  NPD (past) Authorized official
• Treasure Valley Pelvic Health, LLC

  • Physical Therapist
  • Eagle, ID
  • NPI 1689178469
  NPD
• Emergency Physicians of Indianapolis, PC

  • Emergency Medicine Physician
  • Indianapolis, IN
  • NPI 1770538340
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460592000000",
    "number": "1073529202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 S FITNESS PL",
            "address_2": "STE 110",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166552",
            "telephone_number": "208-947-0925",
            "fax_number": "208-947-0926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 S FITNESS PL",
            "address_2": "STE 110",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166552",
            "telephone_number": "208-947-0926",
            "fax_number": "831-636-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEINE",
        "first_name": "CHRISTOPHER",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2016-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "ID",
            "license": "O-0366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Pasillas
• Jeremy Lamont Payne, DC
• James Michael Pease, PTA
• Peine Metabolic Wellness Center
• Peine Osteopathic Medicine PLLC
• Anthony Todd Peppley, PT
• Renee Perran
• Trenton Lucas Perry, PA
• Ramsay L Peters
• Samuel Petersen, DMD

• Neuromusculoskeletal Medicine & OMM Physician in Eagle, ID
• Providers in Eagle, ID by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.