Organization Active NPI

Thrive Chiropractic PLLC

  • Chiropractor
  • Coeur D Alene, ID
National Provider Identifier
1104234236
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1595 Issued in ID
Legal business name
THRIVE CHIROPRACTIC PLLC
Practice address
1230 N Northwood Center CT
Coeur D Alene, ID 83814-4941
Phone
(208) 665-9688
NPI assigned
Aug 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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

Authorized official

Name
Jeffrey Pearson, DCNPI 1770590234
Title
Officer/Owner/Chiropractor
Phone
(208) 665-9688

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CHIA-1595 ID Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X CHIA-1594 ID

Addresses

Primary practice location

1230 N Northwood Center CT
Coeur D Alene, ID 83814-4941

Mailing address

PO Box 546
Cardiff, CA 92007-0546
Phone (760) 436-7671

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191211000779 ID Part B Supplier - Clinic/Group Practice 3375976053 Receives reassigned benefits from 2 practitioners
Practice locations: Coeur D Alene, ID

National Provider Directory

National Provider Directory

Locations

1230 N Northwood Center Ct
Coeur D Alene, ID 83814
Phone (208) 665-9688

1230 N Northwood Center Ct
Ste A
Coeur D Alene, ID 83814
Phone (208) 655-9688

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406851200000",
    "number": "1104234236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 546",
            "city": "CARDIFF",
            "state": "CA",
            "postal_code": "920070546",
            "telephone_number": "760-436-7671",
            "fax_number": "760-797-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 N NORTHWOOD CENTER CT",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144941",
            "telephone_number": "208-665-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-01",
        "last_updated": "2014-08-01",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OFFICER/OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "208-665-9688",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1595",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1594",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; 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.