Active NPI
Luke Corone Mayes, DC
- Chiropractor
- Boise, ID
National Provider Identifier
1093883639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIA-981
- Practice address
- 5975 W Overland Rd
Boise, ID 83709-3012 - Phone
- (208) 375-9000
- Fax
- (208) 375-9032
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIA-981 | ID | Primary |
Addresses
Primary practice location
5975 W Overland Rd
Boise, ID 83709-3012
Mailing address
12166 W Patrina Dr
Boise, ID 83713-1016
Phone (208) 375-9000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 334226 | Other | ID | BLUE SHIELD # |
| C2631 | Other | ID | BLUE CROSS # |
| 8067623 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA-981 | ID | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1093883639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12166 W PATRINA DR",
"city": "BOISE",
"state": "ID",
"postal_code": "837131016",
"telephone_number": "208-375-9000",
"fax_number": "208-375-9032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5975 W OVERLAND RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837093012",
"telephone_number": "208-375-9000",
"fax_number": "208-375-9032"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYES",
"first_name": "LUKE",
"middle_name": "CORONE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ID",
"license": "CHIA-981",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD #",
"identifier": "334226",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS #",
"identifier": "C2631",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8067623",
"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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.