Jake W Sanford, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1817 Issued in ID

Practice address

749 N Overland Ave
Burley, ID 83318-3440

Phone

(208) 260-0917

Fax

(208) 261-5004

NPI assigned

Feb 23, 2018

Last updated

Sep 9, 2024By the provider in NPPES

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

Western States College of Chiropractic, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• Mini-Cassia Chiropractic & Sports Medicine PLLC

  • Chiropractor
  • Burley, ID
  • NPI 1942705546
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1184125288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 MACS AVE",
            "city": "HEYBURN",
            "state": "ID",
            "postal_code": "833369734",
            "telephone_number": "208-670-5450",
            "fax_number": "208-261-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 N OVERLAND AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833183440",
            "telephone_number": "208-260-0917",
            "fax_number": "208-261-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "JAKE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-23",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Calvin Root, D.O.
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• Tiffany Schenk, RN
• Brian Sterling Schiffman, DO
• Bret R. Seamons, O.D.
• Samantha S Searle
• Seasons Dental

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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.