Dr. Michael D. Rae, DC, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

DR. MICHAEL D. RAE, DC, PLLC

Practice address

1843 S Broadway Ave Ste 203a
Boise, ID 83706-3862

Phone

(208) 985-3233

NPI assigned

Aug 17, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Michael D Rae, DCNPI 1194057802

Title

Owner/ Chiropractor

Phone

(208) 985-3233

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

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

• Michael D. Rae, D.C.

  • Chiropractor
  • Boise, ID
  • NPI 1194057802
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1437877321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 S GRANT AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063529",
            "telephone_number": "208-985-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1843 S BROADWAY AVE STE 203A",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063862",
            "telephone_number": "208-985-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MICHAEL D. RAE, DC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-17",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A",
        "authorized_official_last_name": "RAE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/ CHIROPRACTOR",
        "authorized_official_telephone_number": "208-985-3233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO STATE BOARD OF CHIROPRACTIC PHYSICIAN'S",
            "identifier": "CHIA-1332",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 Jun 22, 2023; 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.