Jennifer Lynn Anacker, DC
Individual provider Active NPI Chiropractor · Boise, ID
NPI 1124153432 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124153432
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CHIR997 (ID)
- Practice address
- 300 Main Street
Suite 103
Boise, ID 83702 - Phone
- (208) 287-2299
- Fax
- (208) 287-2298
- NPI assigned
- Feb 23, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - West Sunnyvale, 2002
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Anacker Clinic of Chiropractic, P.C.
Practice addresses (Care Compare)
300 W Main St
Suite 103
Boise, ID 83702-7725
Phone (208) 288-1776
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050216000050 | ID | Practitioner - Chiropractic | 0446202949 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIR997 | ID | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anacker Clinic of Chiropractic, P.C. | Chiropractor | Current |
Accepting new patients |
Locations
300 W Main St
Ste 103
Boise, ID 83702
Phone (208) 287-2299
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIR997 | ID | Yes |
Addresses
Primary practice location
300 Main Street
Suite 103
Boise, ID 83702
Mailing address
PO Box 2663
Boise, ID 83701
Phone (208) 287-2299
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010157936 | Other | ID | MERIDRAN OFFICE |
| C3548 | Other | BLUE CROSS OF IDAHO | |
| 000010139825 | Other | ID | BLUE SHIELD BOISE OFFICE |
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 Jul 8, 2007. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.