Clifton Choong-Shin Andrews, D.C. – Chiropractor

Key facts

NPI: 1245367135
Entity type: Individual (NPI type 1)
Primary specialty: Chiropractor 111N00000X
License: CHIA-988 (ID)
Practice address: 285 E 4TH N
Mountain Home, ID 83647-2716
Phone: (208) 587-3345
Fax: (208) 587-7473
NPI assigned: Feb 27, 2007
Sex: Male
Sole proprietor: Yes

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.

Wear & Associates DC PA Chiropractor · Nampa, ID · NPI 1679567564

NPD (past) CHIROPRACTOR

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
CHIA-988	ID	MD	Chiropractor

Practice roles

Organization	Specialty	Status	New patients
Wear & Associates DC PA	Chiropractor	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor	111N00000X	CHIA-988	ID	Yes

Addresses

Primary practice location

285 E 4TH N
Mountain Home, ID 83647-2716

Mailing address

130 War Eagle Dr
Mountain Home, ID 83647-3784
Phone (208) 587-4106

Other identifiers

Identifier	Type	State	Issuer
000010144146	Other	ID	REGENCE BLUE SHIELD
C3530	Other	ID	BLUE CROSS OF IDAHO

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245367135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 WAR EAGLE DR",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836473784",
            "telephone_number": "208-587-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 E 4TH N",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472716",
            "telephone_number": "208-587-3345",
            "fax_number": "208-587-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "CLIFTON",
        "middle_name": "CHOONG-SHIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010144146",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "C3530",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, ID

All providers in Mountain Home, ID · Chiropractor in Idaho

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.