Bridgewater Chiropractic and Soft Tissue Center PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1500 Issued in ID

Legal business name

BRIDGEWATER CHIROPRACTIC AND SOFT TISSUE CENTER PLLC

Practice address

640 N Thornton St
Post Falls, ID 83854

Phone

(208) 262-8166

NPI assigned

Jul 12, 2016

Last updated

Jul 12, 2016By 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

Jedediah Badders, D.C.NPI 1932474160

Title

Owner

Phone

(208) 262-8166

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jedediah Daniel Badders, D.C.

  • Chiropractor
  • Bentonville, AR
  • NPI 1932474160
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1093167280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 N THORNTON ST",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "83854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 N THORNTON ST",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "83854",
            "telephone_number": "208-262-8166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWATER CHIROPRACTIC AND SOFT TISSUE CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-12",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "BADDERS",
        "authorized_official_first_name": "JEDEDIAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-262-8166",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Eldridge Boykin
• Chaney M Boyle, PHARMD
• Nicholas Wade Bozarth, PA-C
• Sara Bradley, FNP
• Mary Breyer, LMT
• Jennifer Lynn Briggs, PA-C
• Paul F Brillhart, M.D.
• Madelyn Brindza, RDN, ACSM-EP
• Jacquelyn Bonnie Brooks, C-FNP
• Faith Marion Broughton

• Chiropractor in Post Falls, ID
• Providers in Post Falls, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.