Neville Spinal Balance PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

CHIA-1331 Issued in ID

Legal business name

NEVILLE SPINAL BALANCE PLLC

Practice address

2145 West Broadway Street
Idaho Falls, ID 83402-2904

Phone

(208) 522-3130

NPI assigned

Feb 17, 2009

Organization subpart

No

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

Authorized official

Name

Trever Neville, D.C.NPI 1700031515

Title

Owner

Phone

(208) 522-3130

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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.

• Trever L Neville, D.C.

  • Chiropractor
  • Idaho Falss, ID
  • NPI 1700031515
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1234828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591315200000",
    "number": "1104065093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 WEST BROADWAY STREET",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834022904",
            "telephone_number": "208-522-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 WEST BROADWAY STREET",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834022904",
            "telephone_number": "208-522-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEVILLE SPINAL BALANCE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-17",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A",
        "authorized_official_last_name": "NEVILLE",
        "authorized_official_first_name": "TREVER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-522-3130",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ID",
            "license": "CHIA-1331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; 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.