NPIMap

Organization Active NPI

Blue MTN Chiropractic

  • Chiropractor
  • Meridian, ID
National Provider Identifier
1194873471
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BLUE MTN CHIROPRACTIC
Practice address
280 E Corporate Dr
Ste 130
Meridian, ID 83642-2951
Phone
(208) 846-8400
NPI assigned
Jan 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Douglas Wayne Brewer, D.C.NPI 1326128224
Title
Owner
Phone
(208) 846-8400

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X ID Primary

Addresses

Primary practice location

280 E Corporate Dr
Ste 130
Meridian, ID 83642-2951

Mailing address

280 E Corporate Dr
Ste 130
Meridian, ID 83642-2951
Phone (208) 846-8400

National Provider Directory

National Provider Directory

Locations

280 E Corporate Dr
Ste 130
Meridian, ID 83642
Phone (208) 287-2032

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1194873471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 E CORPORATE DR",
            "address_2": "STE 130",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422951",
            "telephone_number": "208-846-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 E CORPORATE DR",
            "address_2": "STE 130",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422951",
            "telephone_number": "208-846-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE MTN CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-846-8400",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.