Irwin Mulnick, D.C., C.C.S.P.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

CHIA578 Issued in ID

Practice address

201 Park St.
McCall, ID 83638-1005

Phone

(208) 634-8129

Fax

(208) 634-7651

NPI assigned

Apr 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

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.

Enrollment records 1

Specialty

ChiropracticAlso: Hospice/Palliative Care, Pain Management, Preventive Medicine, Sports Medicine

Education

Western States College of Chiropractic, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Back Country Chiropractic and Wellness Center Inc.

  • Sports Physician Chiropractor
  • McCall, ID
  • NPI 1861555286
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1083737472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST.",
            "address_2": "PO BOX 1005",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836381005",
            "telephone_number": "208-634-8129",
            "fax_number": "208-634-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PARK ST.",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836381005",
            "telephone_number": "208-634-8129",
            "fax_number": "208-634-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULNICK",
        "first_name": "IRWIN",
        "credential": "D.C., C.C.S.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "ID",
            "license": "CHIA578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD,IRWINMULNICK",
            "identifier": "000010019939",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS, IRWIN MULNICK",
            "identifier": "C5782",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katrina M. McKellips, D.O.
• Eric Mikkelsen, LAMFT
• Meghan Eileen Minshall, LPC
• Jennifer Moon, MA
• Thomas L Moore, LCPC
• Linda Joy Uma Mulnick, D.C., D.A.B.C.I.
• My Hearing Centers, LLC
• Tamara Nagoda, M.S.
• Mindy Newby, OTR, ATC
• Shane Lee Newton, DMD

• Sports Physician Chiropractor in McCall, ID
• Providers in McCall, ID by specialty
• Sports Physician Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.