Organization Active NPI

Schreck Chiropractic and Wellness

  • Chiropractor
  • Emmett, ID
National Provider Identifier
1487065397
Registry record updated May 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA1512 Issued in ID
Legal business name
SCHRECK CHIROPRACTIC AND WELLNESS
Practice address
701 S Washington Ave
Emmett, ID 83617-3526
Phone
(208) 365-1392
Fax
(208) 365-4950
NPI assigned
May 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2014

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

Authorized official

Name
Mr. Jason Chirstopher Schreck, DCNPI 1417295619
Title
Chiropractor
Phone
(208) 365-1392

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 CHIA1512 ID Primary

Addresses

Primary practice location

701 S Washington Ave
Emmett, ID 83617-3526

Mailing address

701 S Washington Ave
Emmett, ID 83617-3526
Phone (208) 365-1392

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140827000034 ID Part B Supplier - Clinic/Group Practice 5395963789 Receives reassigned benefits from 1 practitioner
Practice locations: Emmett, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1399939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399939200000",
    "number": "1487065397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S WASHINGTON AVE",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836173526",
            "telephone_number": "208-365-1392",
            "fax_number": "208-365-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S WASHINGTON AVE",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836173526",
            "telephone_number": "208-365-1392",
            "fax_number": "208-365-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHRECK CHIROPRACTIC AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-13",
        "last_updated": "2014-05-13",
        "status": "A",
        "authorized_official_last_name": "SCHRECK",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "CHIRSTOPHER",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "208-365-1392",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA1512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emmett, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; 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.