Active NPI
Kolton William Donovan, DC
- Chiropractor
- Meridian, ID
National Provider Identifier
1245944628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIA-2318
- Practice address
- 2090 S Eagle Rd
Meridian, ID 83642-6707 - Phone
- (208) 921-1112
- NPI assigned
- Jan 10, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIA-2318 | ID | Primary |
Addresses
Primary practice location
2090 S Eagle Rd
Meridian, ID 83642-6707
Mailing address
2090 S Eagle Rd
Meridian, ID 83642-6707
Phone (208) 921-1112
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CHIA-2318 | Other | ID | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA-2318 | ID | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673308800000",
"number": "1245944628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2090 S EAGLE RD",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836426707",
"telephone_number": "208-921-1112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2090 S EAGLE RD",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836426707",
"telephone_number": "208-921-1112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONOVAN",
"first_name": "KOLTON",
"middle_name": "WILLIAM",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-01-10",
"last_updated": "2023-01-10",
"certification_date": "2023-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ID",
"license": "CHIA-2318",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "CHIA-2318",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.