Boise Sports Chiropractic Clinic

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

C-4918 Issued in ID

Legal business name

BOISE SPORTS CHIROPRACTIC CLINIC

Practice address

3314 N Cole Rd
Boise, ID 83704-4403

Phone

(208) 377-9930

NPI assigned

Jul 2, 2007

Organization subpart

No

Name

Dr. Kevin Hearon, D.C., C.C.S.PNPI 1225230972

Title

Owner

Phone

(208) 377-9930

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

• Kevin G Hearon, D.C., C.C.S.P

  • Sports Physician Chiropractor
  • Boise, ID
  • NPI 1225230972

  Chiropractor

  NPD (past) Authorized official
• Nathaniel John Hearon, DC

  • Chiropractor
  • Boise, ID
  • NPI 1134876451
  NPD (past)
• Gary D Musgrave, D.C.

  • Sports Physician Chiropractor
  • Boise, ID
  • NPI 1003930967

  Sports Physician

  NPD (past)
• Andrew John Garner, D.C.

  • Chiropractor
  • Manhattan, IL
  • NPI 1932491354
  NPD (past)

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 11, 2025.

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1114124138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3314 N COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3314 N COLE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044403",
            "telephone_number": "208-377-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOISE SPORTS CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "HEARON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-377-9930",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., C.C.S.P"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "C-4918",
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "ID",
            "license": "C-4918",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "ID",
            "license": "C-4918",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "ID",
            "license": "C-4918",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": "ID",
            "license": "C-4918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO LICENSE NO.",
            "identifier": "C-4918",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Boise, ID
• Orthopedic Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.