Jeremy W Hale, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-927 Issued in ID

Practice address

445 W Chubbuck Rd
Ste a
Chubbuck, ID 83202-2308

Phone

(208) 637-8800

NPI assigned

Feb 28, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Chubbuck Chiropractic PA

  • Chiropractor
  • Chubbuck, ID
  • NPI 1508993189
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265569842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4880 TRENT",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "83202",
            "telephone_number": "208-637-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 W CHUBBUCK RD",
            "address_2": "STE A",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022308",
            "telephone_number": "208-637-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "JEREMY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peyton Mallory Green, LMSW
• Angela Jade Griffin
• Brookelle Smith Gunn, PA
• Steven Haack, PHARMD
• Michael John Haderlie, MD
• Hancock Dental
• Tad E Hancock, DDS
• Hannah's Place LLC
• Charlie N Hansen, LPC
• Lizarose Y. T. Hansen, CERTIFIED FAMILY HOM

• Chiropractor in Chubbuck, ID
• Providers in Chubbuck, ID by specialty
• Chiropractor in Idaho

• 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.
• 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.