Douglas Scott Fellows, D.C.
Individual provider Active NPI Chiropractor · Preston, ID
NPI 1215326475 · NPPES record last updated Jan 12, 2015
Key facts
- NPI
- 1215326475
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CHIA-1615 (ID)
- Practice address
- 122 N State St
Preston, ID 83263-1143 - Phone
- (208) 852-0083
- NPI assigned
- Jan 12, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Western States College of Chiropractic, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
8 S State St
Preston, ID 83263-1243
Phone (208) 852-2240
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150312001891 | ID | Practitioner - Chiropractic | 7618293416 |
Reassigns benefits to 1 organization Practice locations: Preston, ID |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA-1615 | ID | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fellows Chiropractic LLC | Current |
Accepting new patients |
Locations
1096 Erikson Dr
Rexburg, ID 83440
Phone (208) 656-3205
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIA-1615 | ID | Yes |
Addresses
Primary practice location
122 N State St
Preston, ID 83263-1143
Mailing address
122 N State St
Preston, ID 83263-1143
Phone (208) 852-0083
Other providers in Preston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.