Individual provider Active NPI

Christie Ann Hafer, D.C.

  • Chiropractor
  • Eagle, ID
National Provider Identifier
1396980066
Registry record updated Oct 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1333 Issued in ID
Practice address
435 E Shore Dr
Suite 110
Eagle, ID 83616-5753
Phone
(208) 938-9548
Fax
(208) 938-9494
NPI assigned
Dec 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-1333 ID Primary

Addresses

Primary practice location

435 E Shore Dr
Suite 110
Eagle, ID 83616-5753

Mailing address

435 E Shore Dr
Suite 110
Eagle, ID 83616-5753
Phone (208) 938-9548

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

LicenseStateTypeSpecialty
CHIA-1333IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Purpose Driven Chiropractic PC Chiropractor Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285891200000",
    "number": "1396980066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 E SHORE DR",
            "address_2": "SUITE 110",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165753",
            "telephone_number": "208-938-9548",
            "fax_number": "208-938-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 E SHORE DR",
            "address_2": "SUITE 110",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165753",
            "telephone_number": "208-938-9548",
            "fax_number": "208-938-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFER",
        "first_name": "CHRISTIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-10",
        "last_updated": "2010-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2010; 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.