Jerome Chiropractic Clinic PLLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

CHIA-650 Issued in ID

Legal business name

JEROME CHIROPRACTIC CLINIC PLLC

Practice address

213 S Lincoln Ave
Jerome, ID 83338-2624

Phone

(208) 324-0222

Fax

(208) 324-0223

NPI assigned

Jun 8, 2011

Last updated

Jun 8, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark McClain Saccoman, D.C.

Title

President

Phone

(208) 324-0222

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1093009847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833380632",
            "telephone_number": "208-324-0222",
            "fax_number": "208-324-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 S LINCOLN AVE",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833382624",
            "telephone_number": "208-324-0222",
            "fax_number": "208-324-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEROME CHIROPRACTIC CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-08",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "SACCOMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "MCCLAIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-324-0222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "ID",
            "license": "CHIA-650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Guadalupe Hurtado
• James S Irwin, M.D.
• Christine M Ivie, LPC - 815
• Troy M Jackman, PHARMD
• Tonya Lynn Jepson, LPC
• Jerome Family Chiropractic
• Jerome Toothtown PLLC
• Johnson Chiropractic Clinic
• Laura Marie Johnson Stevenson, BS DC CCEP
• Brian Lee Johnson, M.D.

• Health Service Clinic/Center in Jerome, ID
• Providers in Jerome, ID by specialty
• Health Service Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.