Adam James Manninen, DC
Individual provider Active NPI Chiropractor · Bozeman, MT
NPI 1225344724 · NPPES record last updated Jun 15, 2020
Key facts
- NPI
- 1225344724
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CHIA-2019 (ID)
- Practice address
- 3508 Laramie Dr Ste 3
Bozeman, MT 59718-2006 - Phone
- (989) 387-8456
- NPI assigned
- Aug 23, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2009
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1207 Michigan St
Suite B
Sandpoint, ID 83864-6608
Phone (208) 265-2225
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200706000524 | ID | Practitioner - Chiropractic | 0042405946 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA-2019 | ID | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manninen PLLC | Chiropractor | Current |
Accepting new patients |
| Westra Chiropractic Center PLLC | Chiropractor | Past | Accepting new patients |
| Mihin Chiropractic Clinic, PLLC | Chiropractor | Past |
Accepting new patients |
Locations
1207 Michigan St
Ste B
Sandpoint, ID 83864
Phone (208) 263-9536
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | CHIA-2019 | ID | Yes |
Addresses
Primary practice location
3508 Laramie Dr Ste 3
Bozeman, MT 59718-2006
Mailing address
1207 Michigan St
Ste B
Sandpoint, ID 83864-6608
Phone (208) 265-2225
NPI Registry JSON
{
"created_epoch": "1282521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592179200000",
"number": "1225344724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1207 MICHIGAN ST",
"address_2": "STE B",
"city": "SANDPOINT",
"state": "ID",
"postal_code": "838646608",
"telephone_number": "208-265-2225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3508 LARAMIE DR STE 3",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597182006",
"telephone_number": "989-387-8456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNINEN",
"first_name": "ADAM",
"middle_name": "JAMES",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-23",
"last_updated": "2020-06-15",
"certification_date": "2020-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "ID",
"license": "CHIA-2019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bozeman, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2020. 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.