Organization Active NPI

McCall Chiropractic Inc.

  • Chiropractor
  • McCall, ID
National Provider Identifier
1184782963
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA914 Issued in ID
Legal business name
MCCALL CHIROPRACTIC INC.
Practice address
301 E Park St
McCall, ID 83638-3803
Phone
(086) 348-2712
Fax
(208) 634-3526
NPI assigned
Dec 5, 2006
Last updated
Feb 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Authorized official

Name
William Guy Jeppe IIINPI 1508922311
Title
Owner
Phone
(208) 634-8271

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 CHIA914 ID Primary

Addresses

Primary practice location

301 E Park St
McCall, ID 83638-3803

Mailing address

PO Box 931
McCall, ID 83638
Phone (208) 634-8271

Other identifiers 2

IdentifierTypeStateIssuer
C1773OtherIDBLUE CROSS
000010028703OtherIDREGENCE BL SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071219000651 ID Part B Supplier - Clinic/Group Practice 5092805671 Receives reassigned benefits from 1 practitioner
Practice locations: McCall, ID

National Provider Directory

National Provider Directory

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": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1184782963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 931",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "83638",
            "telephone_number": "208-634-8271",
            "fax_number": "208-634-8271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E PARK ST",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836383803",
            "telephone_number": "086-348-2712",
            "fax_number": "208-634-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCALL CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A",
        "authorized_official_last_name": "JEPPE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "GUY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-634-8271",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "C1773",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BL SHIELD",
            "identifier": "000010028703",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McCall, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.