Individual provider Active NPI

George Chester Squire, D.C.

  • Chiropractor
  • Middleton, ID
National Provider Identifier
1255408399
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA396 Issued in ID
Practice address
111 E Main St
Middleton, ID 83644-5705
Phone
(208) 585-3657
Fax
(208) 585-3658
NPI assigned
Nov 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA396 ID Primary

Addresses

Primary practice location

111 E Main St
Middleton, ID 83644-5705

Mailing address

111 E Main St
Middleton, ID 83644-5705
Phone (208) 585-3657

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

LicenseStateTypeSpecialty
CHIA396IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Middleton Upper Cervical Chiropractic PLLC Chiropractor CurrentSince Jul 24, 2022 Accepting new patients

Locations

111 E Main St
Middleton, ID 83644
Phone (208) 585-3657

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255408399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E MAIN ST",
            "city": "MIDDLETON",
            "state": "ID",
            "postal_code": "836445705",
            "telephone_number": "208-585-3657",
            "fax_number": "208-585-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E MAIN ST",
            "city": "MIDDLETON",
            "state": "ID",
            "postal_code": "836445705",
            "telephone_number": "208-585-3657",
            "fax_number": "208-585-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRE",
        "first_name": "GEORGE",
        "middle_name": "CHESTER",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleton, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.