Individual provider Active NPI

Raymond Keith McKim, D.C.

  • Neurology Chiropractor
  • Nampa, ID
National Provider Identifier
1477516169
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
CHIA-459 Issued in ID
Practice address
2023 12TH Ave Rd
Nampa, ID 83686-6311
Phone
(208) 467-5756
Fax
(208) 467-1368
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X CHIA-459 ID Primary

Addresses

Primary practice location

2023 12TH Ave Rd
Nampa, ID 83686-6311

Mailing address

2023 12TH Ave Rd
Nampa, ID 83686-6311
Phone (208) 467-5756

Other identifiers 1

IdentifierTypeStateIssuer
002702400MedicaidID

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-459IDMDNeurology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin Chiropractic PastSince Oct 1, 2023 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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477516169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866311",
            "telephone_number": "208-467-5756",
            "fax_number": "208-467-1368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 12TH AVE RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866311",
            "telephone_number": "208-467-5756",
            "fax_number": "208-467-1368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIM",
        "first_name": "RAYMOND",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "ID",
            "license": "CHIA-459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002702400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.