Anacker Clinic of Chiropractic, P.C.
Organization Active NPI Chiropractor · Boise, ID
NPI 1114127149 · NPPES record last updated Jan 9, 2018
Key facts
- NPI
- 1114127149
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- CHIA-997 (ID)
- Legal business name
- ANACKER CLINIC OF CHIROPRACTIC, P.C.
- Practice address
- 300 Main St
Boise, ID 83702-7700 - Phone
- (208) 287-2299
- NPI assigned
- Jul 18, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Jennifer Lynn Anacker, D.C.
- Title
- Chiropractor/President
- Phone
- (208) 287-2299
Practitioners 2
-
Austin Diffey, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050212000064 | ID | Part B Supplier - Clinic/Group Practice | 9537111034 |
Receives reassigned benefits from 2 practitioners Practice locations: Boise, ID |
National Provider Directory
Locations
300 W Main St
Ste 103
Boise, ID 83702
Phone (208) 287-2299
300 W Main St
Boise, ID 83702
Phone (208) 287-2299
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | CHIA-997 | ID | Yes |
Addresses
Primary practice location
300 Main St
Boise, ID 83702-7700
Mailing address
PO Box 2663
Boise, ID 83701-2663
Phone (208) 287-2299
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1378832 | Other | ID | MEDICARE GROUP |
| 1674929 | Other | ID | MEDICARE INDIVIDUAL |
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.