Sirucek Chiropractic Neurology Clinic, Inc.

Primary specialty

Neurology ChiropractorTaxonomy code 111NN0400X

License

CHIA1276 Issued in ID

Legal business name

SIRUCEK CHIROPRACTIC NEUROLOGY CLINIC, INC.

Practice address

3080 E Gentry Way
Suite 110
Meridian, ID 83642-3544

Phone

(208) 345-7262

Fax

(208) 343-1953

NPI assigned

Jun 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Dax Kendrick Sirucek, DC, DACNBNPI 1669654935

Title

Owner

Phone

(208) 345-7262

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dax Sirucek, DC, DACNB

  • Neurology Chiropractor
  • Meridian, ID
  • NPI 1669654935
  Medicare reassignment Care Compare group NPD Authorized official
• Maria Teresa Gomez Sirucek, D.C.

  • Chiropractor
  • Meridian, ID
  • NPI 1104055383

  Neurology

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1093975302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 E GENTRY WAY",
            "address_2": "SUITE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423544",
            "telephone_number": "208-345-7262",
            "fax_number": "208-343-1953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 E GENTRY WAY",
            "address_2": "SUITE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836423544",
            "telephone_number": "208-345-7262",
            "fax_number": "208-343-1953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIRUCEK CHIROPRACTIC NEUROLOGY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-10",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "SIRUCEK",
        "authorized_official_first_name": "DAX",
        "authorized_official_middle_name": "KENDRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-345-7262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, DACNB"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "ID",
            "license": "CHIA1276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott C Simpson, M.D.
• Spencer Andrew Simpson, APRN-CNP
• Russell Neal Singleton, PA-C
• Kartika Singpraseuth, PHARMD
• Sinus Surgery Center Idaho PA
• Dax Sirucek, DC, DACNB
• Maria Teresa Gomez Sirucek, D.C.
• Sisc Anesthesia Inc
• Amanda Sissom
• Kelly Siudzinski, M.D.

• Neurology Chiropractor in Meridian, ID
• Providers in Meridian, ID by specialty
• Neurology Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; 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.