Organization Active NPI

Aspen Ridge Chiropractic

  • Chiropractor
  • Ammon, ID
National Provider Identifier
1164780557
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ASPEN RIDGE CHIROPRACTIC
Practice address
3526 Briar Creek LN
Ammon, ID 83406-4728
Phone
(208) 552-8866
NPI assigned
Apr 24, 2012
Last updated
May 11, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2012

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

Authorized official

Name
Dr. Michael Chad Miller, D.C.NPI 1093048340
Title
Doctor
Phone
(208) 552-8866

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

3526 Briar Creek LN
Ammon, ID 83406-4728

Mailing address

3526 Briar Creek LN
Ammon, ID 83406-4728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120508000122 ID Part B Supplier - Clinic/Group Practice 3779745872 Receives reassigned benefits from 1 practitioner
Practice locations: Idaho Falls, ID

National Provider Directory

National Provider Directory

Locations

3526 Briar Creek Ln
Ammon, ID 83406
Phone (208) 552-8866

3419 Merlin Dr
Idaho Falls, ID 83404
Phone (208) 552-8866

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1164780557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3526 BRIAR CREEK LN",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834064728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3526 BRIAR CREEK LN",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834064728",
            "telephone_number": "208-552-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPEN RIDGE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-24",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CHAD",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "208-552-8866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ammon, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.