NPIMap

Organization Active NPI

Awic, P.C.

Doing business as Advantage Walk-In Chiropractic

  • Chiropractor
  • Boise, ID
National Provider Identifier
1346436359
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1137 Issued in ID
Legal business name
AWIC, P.C.
Doing business as
Advantage Walk-In Chiropractic
Practice address
3211 N Milwaukee St
Boise, ID 83704-4446
Phone
(208) 375-2225
Fax
(208) 375-2276
NPI assigned
Sep 24, 2007
Last updated
Jan 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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

Authorized official

Name
Dr. Andrew C Kidder, DCNPI 1710048681
Title
Managing Partner
Phone
(208) 375-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-1137 ID Primary

Addresses

Primary practice location

3211 N Milwaukee St
Boise, ID 83704-4446

Mailing address

3211 N Milwaukee St
Boise, ID 83704-4446
Phone (208) 375-2225

Other names 1

  • Advantage Walk-In Chiropractic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120323000257 ID Part B Supplier - Clinic/Group Practice 1557521853 Receives reassigned benefits from 3 practitioners
Practice locations: Boise, ID

National Provider Directory

National Provider Directory

Locations

3211 N Milwaukee St
Boise, ID 83704
Phone (208) 375-2225

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262563200000",
    "number": "1346436359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 N MILWAUKEE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044446",
            "telephone_number": "208-375-2225",
            "fax_number": "208-375-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 N MILWAUKEE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044446",
            "telephone_number": "208-375-2225",
            "fax_number": "208-375-2276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2010-01-04",
        "status": "A",
        "authorized_official_last_name": "KIDDER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "208-375-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Walk-In Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 4, 2010; 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.