Ellison Family Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-845 Issued in ID

Legal business name

ELLISON FAMILY CHIROPRACTIC

Practice address

3225 W Bavaria St
Suite 101
Eagle, ID 83616-5413

Phone

(208) 884-8848

Fax

(208) 884-8802

NPI assigned

Feb 18, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Gary Craig Ellison, D.C.NPI 1780883389

Title

Owner

Phone

(208) 884-8848

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 3

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

• Gary Craig Ellison, D.C.

  • Chiropractor
  • Eagle, ID
  • NPI 1780883389
  Medicare reassignment NPD Authorized official
• Kristin Moore, D.C.

  • Chiropractor
  • Eagle, ID
  • NPI 1457665135
  Medicare reassignment NPD
• Ryan Ballard Weed, D.C.

  • Chiropractor
  • Meridian, ID
  • NPI 1386966315
  NPD (past)

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

{
    "created_epoch": "1266451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333497600000",
    "number": "1508188400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3225 W BAVARIA ST",
            "address_2": "SUITE 101",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165413",
            "telephone_number": "208-884-8848",
            "fax_number": "208-884-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 W BAVARIA ST",
            "address_2": "SUITE 101",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165413",
            "telephone_number": "208-884-8848",
            "fax_number": "208-884-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLISON FAMILY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-18",
        "last_updated": "2012-04-04",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-884-8848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807028500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• WKL Edgerly, COTA/L
• Edgewood Spring Creek Eagle, LLC
• Chloe Edmiston
• Julie Eisele, PHARM.D.
• Stan A Eisele, MD
• Gary Craig Ellison, D.C.
• Emp Idaho Nampa, LLC
• Enhanced Aesthetics and Wellness
• Evan Hathaway DDS PA
• Lyndsey Evans

• Chiropractor in Eagle, ID
• Providers in Eagle, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; 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.