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

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

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

Title

Owner

Phone

(208) 377-9930

Specialties & licenses 5

Addresses

Other identifiers 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kevin G Hearon, D.C., C.C.S.P

  • Sports Physician Chiropractor
  • Boise, ID
  • NPI 1225230972
  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
  NPD (past)
• Andrew John Garner, D.C.

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

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

{
    "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": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "C-4918",
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "ID",
            "license": "C-4918",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "ID",
            "license": "C-4918",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "ID",
            "license": "C-4918",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "ID",
            "license": "C-4918",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO LICENSE NO.",
            "identifier": "C-4918",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthopedic Chiropractor in Boise, ID
• Providers in Boise, ID by specialty
• 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.