NPIMap

Organization Active NPI

Salmon River Chiropractic Inc.

  • Chiropractor
  • Salmon, ID
National Provider Identifier
1225068059
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1182 Issued in ID
Legal business name
SALMON RIVER CHIROPRACTIC INC.
Practice address
104 S Daisy St
Suite a
Salmon, ID 83467-4333
Phone
(208) 756-5000
NPI assigned
Jul 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jennifer Victoria Coffey, D.C.NPI 1891726196
Title
Co - President
Phone
(208) 879-6754

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
Chiropractor 111N00000X CHIA-1182 ID Primary

Addresses

Primary practice location

104 S Daisy St
Suite a
Salmon, ID 83467-4333

Mailing address

104 S Daisy St
Suite a
Salmon, ID 83467-4333
Phone (208) 756-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060822000624 ID Part B Supplier - Clinic/Group Practice 5092718536 Receives reassigned benefits from 3 practitioners
Practice locations: Salmon, ID

National Provider Directory

National Provider Directory

Locations

104 S Daisy St
#A
Salmon, ID 83467
Phone (208) 756-2202

104 S Daisy St
Ste A
Salmon, ID 83467
Phone (208) 756-2202

Practitioners & affiliated clinicians

Practitioners 5

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": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225068059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S DAISY ST",
            "address_2": "SUITE A",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834674333",
            "telephone_number": "208-756-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S DAISY ST",
            "address_2": "SUITE A",
            "city": "SALMON",
            "state": "ID",
            "postal_code": "834674333",
            "telephone_number": "208-756-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALMON RIVER CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COFFEY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "VICTORIA",
        "authorized_official_title_or_position": "CO - PRESIDENT",
        "authorized_official_telephone_number": "208-879-6754",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salmon, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.