Organization Active NPI

Mary Jo White Dcpa

  • Chiropractor
  • Post Falls, ID
National Provider Identifier
1194975250
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA713 Issued in ID
Legal business name
MARY JO WHITE DCPA
Practice address
606 N Spokane St
Ste C
Post Falls, ID 83854-5291
Phone
(208) 777-2884
Fax
(208) 777-0277
NPI assigned
Sep 25, 2008
Last updated
Sep 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Authorized official

Name
Mary Jo White Dcpa, DC
Title
Owner
Phone
(208) 777-2884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA713 ID Primary

Addresses

Primary practice location

606 N Spokane St
Ste C
Post Falls, ID 83854-5291

Mailing address

606 N Spokane St
Ste C
Post Falls, ID 83854-5291
Phone (208) 777-2884

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081030000502 ID Part B Supplier - Clinic/Group Practice 6305878323 Receives reassigned benefits from 1 practitioner
Practice locations: Kellogg, ID; Post Falls, ID

National Provider Directory

National Provider Directory

Locations

208 Oregon St
Kellogg, ID 83837
Phone (208) 784-1008

606 N Spokane St
Ste C
Post Falls, ID 83854

810 N Henry St
Ste 390
Post Falls, ID 83854

Practitioners & affiliated clinicians

Practitioners 3

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": "1222300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222300800000",
    "number": "1194975250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 N SPOKANE ST",
            "address_2": "STE C",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545291",
            "telephone_number": "208-777-2884",
            "fax_number": "208-777-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 N SPOKANE ST",
            "address_2": "STE C",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545291",
            "telephone_number": "208-777-2884",
            "fax_number": "208-777-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY JO WHITE DCPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-25",
        "last_updated": "2008-09-25",
        "status": "A",
        "authorized_official_last_name": "WHITE DCPA",
        "authorized_official_first_name": "MARY JO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-777-2884",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.