J. B. Egbert Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA 1449 Issued in ID

Legal business name

J. B. EGBERT CHIROPRACTIC LLC

Practice address

1134 Bond Ave
Rexburg, ID 83440-3582

Phone

(208) 356-8818

Fax

(208) 356-0458

NPI assigned

Aug 16, 2011

Last updated

Aug 24, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jonathan B. Egbert

Title

Owner

Phone

(208) 356-8818

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314144000000",
    "number": "1245519693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1134 BOND AVE",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834403582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1134 BOND AVE",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834403582",
            "telephone_number": "208-356-8818",
            "fax_number": "208-356-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. B. EGBERT CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-16",
        "last_updated": "2011-08-24",
        "status": "A",
        "authorized_official_last_name": "EGBERT",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-356-8818"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA 1449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.