Kenneth Alan Gough, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1501 Issued in ID

Practice address

3040 N Five Mile Rd
Suite C
Boise, ID 83713-5234

Phone

(208) 324-8484

Fax

(208) 321-5084

NPI assigned

Feb 11, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Quick Recovery Chiropractic PLLC

  • Chiropractor
  • Nampa, ID
  • NPI 1245718170
  Medicare reassignment Authorized official
• Ideal Health

  • Chiropractor
  • Boise, ID
  • NPI 1811183023
  NPD (past)

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

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1285966598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 N FIVE MILE RD",
            "address_2": "SUITE C",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135234",
            "telephone_number": "208-324-8484",
            "fax_number": "208-321-5084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 N FIVE MILE RD",
            "address_2": "SUITE C",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135234",
            "telephone_number": "208-324-8484",
            "fax_number": "208-321-5084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGH",
        "first_name": "KENNETH",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-11",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3994",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer G. Gotto, M.D.
• Mariella Elle Gotz, PH.D., LPC, ATR-BC
• Sheryl Kay Goudy, LISW-S
• David Thomas Gough, D.O.
• Elizabeth Kay Gough, LMSW
• Christopher J Goulet, M.D.
• Sara Gourley, LPC
• Makenna Lyn Goutermout, RD, LD
• Amy Louella Gowans
• Annie Goyer

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.