Individual provider Active NPI

Jonathan Jay Lindsey, DC

  • Chiropractor
  • Fruitland, ID
National Provider Identifier
1194748939
Registry record updated Oct 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1197 Issued in ID
Practice address
211 N Whitley Dr
Ste. 4
Fruitland, ID 83619-2704
Phone
(208) 452-7582
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-1197 ID Primary

Addresses

Primary practice location

211 N Whitley Dr
Ste. 4
Fruitland, ID 83619-2704

Mailing address

211 N Whitley Dr
Ste. 4
Fruitland, ID 83619-2704
Phone (208) 452-7582

Other identifiers 3

IdentifierTypeStateIssuer
C5822OtherBLUE CROSS
000010157423OtherIDBLUE SHIELD
807598100MedicaidID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070627000468 ID Practitioner - Chiropractic 5294834578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

211 N Whitley Dr
Suite 4
Fruitland, ID 83619-2486
Phone (208) 452-7582

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-1197IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Total Wellness Chiropractic and Holistic Care LLC Chiropractor CurrentSince Dec 26, 2006 Accepting new patients
Total Wellness Chiropractic and Holistic Care Chiropractor CurrentSince Dec 26, 2006 Accepting new patients

Locations

211 N Whitley Dr
Ste 4
Fruitland, ID 83619
Phone (208) 452-7582

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224892800000",
    "number": "1194748939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N WHITLEY DR",
            "address_2": "STE. 4",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192704",
            "telephone_number": "208-452-7582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N WHITLEY DR",
            "address_2": "STE. 4",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192704",
            "telephone_number": "208-452-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSEY",
        "first_name": "JONATHAN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "C5822",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010157423",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807598100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruitland, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2008; 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.