Jackson Clay Shubin, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-2387 Issued in ID

Practice address

645 S. Woodruff Ave
Idaho Falls, ID 83401

Phone

(208) 552-9886

Fax

(208) 718-9847

NPI assigned

Oct 2, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aspen Managment Services Inc

  • Chiropractor
  • Idaho Falls, ID
  • NPI 1841370053
  Medicare reassignment NPD

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1114745668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 S. WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83401",
            "telephone_number": "208-552-9886",
            "fax_number": "208-718-9847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 S. WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83401",
            "telephone_number": "208-552-9886",
            "fax_number": "208-718-9847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUBIN",
        "first_name": "JACKSON",
        "middle_name": "CLAY",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-2387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Owen M Shirts, O.D.
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• Stacy Short, PHARMD
• Shoulder & Knee Center, PA
• Shon Lorin Shuldberg, LCSW
• Christian T Shull, M.D.
• Braiden R Shumway, DO
• A Shuravloff, DO
• Vance Shurtliff, DPT

• Chiropractor in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.