Organization Active NPI

Eastland Chiropractic, P.a

  • Chiropractor
  • Twin Falls, ID
National Provider Identifier
1396089728
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
EASTLAND CHIROPRACTIC, P.A
Practice address
1126 Eastland Dr N Ste 300
Twin Falls, ID 83301-8951
Phone
(208) 734-7077
Fax
(208) 734-7101
NPI assigned
Nov 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Authorized official

Name
Dr. Noel Senecal, D.C., C.I.R.SNPI 1629236625
Title
Owner
Phone
(208) 734-7077

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1126 Eastland Dr N Ste 300
Twin Falls, ID 83301-8951

Mailing address

1126 Eastland Dr N Ste 300
Twin Falls, ID 83301-8951
Phone (208) 734-7077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130125000034 ID Part B Supplier - Clinic/Group Practice 4486808599 Practice locations: Twin Falls, ID

National Provider Directory

National Provider Directory

Locations

1126 Eastland Dr N
Twin Falls, ID 83301
Phone (208) 734-7077

1126 Eastland Dr N
Ste 300
Twin Falls, ID 83301
Phone (208) 734-7077

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353888000000",
    "number": "1396089728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 EASTLAND DR N STE 300",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833018951",
            "telephone_number": "208-734-7077",
            "fax_number": "208-734-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 EASTLAND DR N STE 300",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833018951",
            "telephone_number": "208-734-7077",
            "fax_number": "208-734-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTLAND CHIROPRACTIC, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A",
        "authorized_official_last_name": "SENECAL",
        "authorized_official_first_name": "NOEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-734-7077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., C.I.R.S"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.