Individual provider Active NPI

Jeffrey Bryan Pease, D.C.

  • Chiropractor
  • Boise, ID
National Provider Identifier
1245306539
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-743 Issued in ID
Practice address
8275 Northview St
Boise, ID 83704-7131
Phone
(208) 323-9000
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-743 ID Primary

Addresses

Primary practice location

8275 Northview St
Boise, ID 83704-7131

Mailing address

2796 W Torana Dr
Meridian, ID 83642-5622
Phone (208) 895-0336

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130731000302 ID Practitioner - Chiropractic 2860633054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8275 Northview
Boise, ID 83704-7131
Phone (208) 323-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-743IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pease Family Chiropractic P.C. Chiropractor CurrentSince Apr 10, 2013 Accepting new patients

Locations

8275 W Northview St
Boise, ID 83704
Phone (208) 323-9000

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1245306539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2796 W TORANA DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425622",
            "telephone_number": "208-895-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8275 NORTHVIEW ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837047131",
            "telephone_number": "208-323-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEASE",
        "first_name": "JEFFREY",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.