Individual provider Active NPI

Kraig Kurtis Knotts, D.C.

  • Sports Physician Chiropractor
  • Eagle, ID
National Provider Identifier
1205883170
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
CHIA-1073 Issued in ID
Practice address
547 S Fitness PL
Suite 110
Eagle, ID 83616-6552
Phone
(208) 939-3986
Fax
(208) 939-7186
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X CHIA-1073 ID Primary

Addresses

Primary practice location

547 S Fitness PL
Suite 110
Eagle, ID 83616-6552

Mailing address

547 S Fitness PL
Suite 110
Eagle, ID 83616-6552
Phone (208) 939-3986

Other identifiers 1

IdentifierTypeStateIssuer
C-4272OtherIDBLUE CROSS OF IDAHO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070119000381 ID Practitioner - Chiropractic 5092716910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

547 S Fitness PL
Suite 110
Eagle, ID 83616-6552
Phone (208) 939-3986

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-1073IDMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Sport & Family Chiropractic PLLC Sports Physician CurrentSince Jan 19, 2007 Accepting new patients

Locations

403 S 11th St
Ste 110
Boise, ID 83702
Phone (208) 343-6900

547 S Fitness Pl
#110
Eagle, ID 83616
Phone (208) 939-3986

Organizations & group practices 1

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1205883170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 S FITNESS PL",
            "address_2": "SUITE 110",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166552",
            "telephone_number": "208-939-3986",
            "fax_number": "208-939-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 S FITNESS PL",
            "address_2": "SUITE 110",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166552",
            "telephone_number": "208-939-3986",
            "fax_number": "208-939-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOTTS",
        "first_name": "KRAIG",
        "middle_name": "KURTIS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "ID",
            "license": "CHIA-1073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "C-4272",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.