Primary Care Chiropractic, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1005 Issued in ID

Legal business name

PRIMARY CARE CHIROPRACTIC, PLLC

Practice address

1004 13TH Ave S
Nampa, ID 83651-4621

Phone

(208) 461-4227

Fax

(208) 461-3411

NPI assigned

Jan 7, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Ronda L. Mattley, D.C.NPI 1902985005

Title

Owner

Phone

(208) 461-4227

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ronda L. Mattley, D.C.

  • Chiropractor
  • Nampa, ID
  • NPI 1902985005
  NPD (past) Authorized official

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1265617401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 13TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514621",
            "telephone_number": "208-461-4227",
            "fax_number": "208-461-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 13TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514621",
            "telephone_number": "208-461-4227",
            "fax_number": "208-461-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "MATTLEY",
        "authorized_official_first_name": "RONDA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-461-4227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "C2979",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "000010141491",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.