Active NPI
Balanced Chiropractic
- Chiropractor
- Nampa, ID
National Provider Identifier
1497413348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- Legal business name
- BALANCED CHIROPRACTIC
- Practice address
- 16730 N Marketplace Blvd
Nampa, ID 83687-7909 - Phone
- (208) 466-4600
- Fax
- (208) 461-9236
- NPI assigned
- Dec 7, 2021
- Organization subpart
- Yes
- Parent organization
- BALANCED CHIROPRACTIC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Justin David Jesperson, DC
- Title
- President
- Phone
- (208) 466-4600
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | Primary |
Addresses
Primary practice location
16730 N Marketplace Blvd
Nampa, ID 83687-7909
Mailing address
16730 N Marketplace Blvd
Nampa, ID 83687-7909
Phone (208) 466-4600
Other names 1
- Balanced Movement Chiropractic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220315001036 | ID | Part B Supplier - Clinic/Group Practice | 6608261441 |
Receives reassigned benefits from 2 practitioners Practice locations: Nampa, ID |
National Provider Directory
National Provider Directory- Part of
- Balanced Chiropractic
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Nampa, ID
- NPI 1649142761
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1638835200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1646438400000",
"number": "1497413348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16730 N MARKETPLACE BLVD",
"city": "NAMPA",
"state": "ID",
"postal_code": "836877909",
"telephone_number": "208-466-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16730 N MARKETPLACE BLVD",
"city": "NAMPA",
"state": "ID",
"postal_code": "836877909",
"telephone_number": "208-466-4600",
"fax_number": "208-461-9236"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BALANCED CHIROPRACTIC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BALANCED CHIROPRACTIC",
"enumeration_date": "2021-12-07",
"last_updated": "2022-03-05",
"certification_date": "2022-01-21",
"status": "A",
"authorized_official_last_name": "JESPERSON",
"authorized_official_first_name": "JUSTIN",
"authorized_official_middle_name": "DAVID",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "208-466-4600",
"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": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Balanced Movement Chiropractic",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Balanced Movement Chiropractic",
"code": "3",
"type": "Doing Business As"
}
]
}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 Mar 5, 2022; 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.