Active NPI
Blake Louis Howard, D.C.
- Sports Physician Chiropractor
- Boise, ID
National Provider Identifier
1285658302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- CHIA-1166
- Practice address
- 4700 N Cloverdale Rd Ste 103
Boise, ID 83713-1067 - Phone
- (208) 658-8326
- Fax
- (208) 658-0100
- NPI assigned
- Jul 26, 2006
- 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 |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | CHIA-1166 | ID | Primary |
Addresses
Primary practice location
4700 N Cloverdale Rd Ste 103
Boise, ID 83713-1067
Mailing address
5658 Bloom St
Boise, ID 83703-3463
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA-1166 | ID | MD | Sports Physician Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285658302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5658 BLOOM ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837033463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 N CLOVERDALE RD STE 103",
"city": "BOISE",
"state": "ID",
"postal_code": "837131067",
"telephone_number": "208-658-8326",
"fax_number": "208-658-0100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOWARD",
"first_name": "BLAKE",
"middle_name": "LOUIS",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "ID",
"license": "CHIA-1166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, 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.