Active NPI
Glen L Westover, D.C.
- Chiropractor
- Pinehurst, ID
National Provider Identifier
1215005277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIA-347
- Practice address
- 301 S Division St
Pinehurst, ID 83850-9767 - Phone
- (208) 682-2122
- Fax
- (208) 682-2825
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIA-347 | ID | Primary |
Addresses
Primary practice location
301 S Division St
Pinehurst, ID 83850-9767
Mailing address
301 S Division St
Pinehurst, ID 83850-9767
Phone (208) 682-2122
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C3555 | Other | ID | BLUE CROSS |
| 000010139794 | Other | ID | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA-347 | ID | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chiropractic Pain Relief Clinic P a | Chiropractor | Past | Accepting new patients |
| Swayze Chiropractic PC | Chiropractor | Past | Accepting new patients |
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215005277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 S DIVISION ST",
"city": "PINEHURST",
"state": "ID",
"postal_code": "838509767",
"telephone_number": "208-682-2122",
"fax_number": "208-682-2825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 S DIVISION ST",
"city": "PINEHURST",
"state": "ID",
"postal_code": "838509767",
"telephone_number": "208-682-2122",
"fax_number": "208-682-2825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESTOVER",
"first_name": "GLEN",
"middle_name": "L",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ID",
"license": "CHIA-347",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "C3555",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "000010139794",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pinehurst, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.