Individual provider Active NPI

Brent Symes, DC

  • Chiropractor
  • Eagle, ID
National Provider Identifier
1508940859
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-2062 Issued in ID
Practice address
20 N Fisher Park Way
Ste 100
Eagle, ID 83616-4709
Phone
(425) 712-9277
Fax
(425) 775-5085
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-2062 ID Primary
Chiropractor 111N00000X CH00034584 WA

Addresses

Primary practice location

20 N Fisher Park Way
Ste 100
Eagle, ID 83616-4709

Mailing address

20 N Fisher Park Way
Ste 100
Eagle, ID 83616-4709
Phone (425) 712-9277

Other identifiers 2

IdentifierTypeStateIssuer
3853SYOtherREGENCE BLUESHIELD RIDER
0213787OtherLABOR AND INDUSTRIES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210817000189 ID Practitioner - Chiropractic 9830197557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20 N Fisher Park Way
Suite 100
Eagle, ID 83616-4709
Phone (208) 297-1414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Family Chiropractic, LLC Chiropractor CurrentSince Mar 1, 2021 Accepting new patients
Legacy Chiropractic PLLC Chiropractor CurrentSince May 19, 2021 Accepting new patients

Locations

20 N Fisher Park Way
Ste 100
Eagle, ID 83616
Phone (206) 313-3733

20120 76th Ave W
Edmonds, WA 98026
Phone (425) 712-9277

Organizations & group practices 2

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1508940859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N FISHER PARK WAY",
            "address_2": "STE 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836164709",
            "telephone_number": "425-712-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 N FISHER PARK WAY",
            "address_2": "STE 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836164709",
            "telephone_number": "425-712-9277",
            "fax_number": "425-775-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYMES",
        "first_name": "BRENT",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-2062",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034584",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUESHIELD RIDER",
            "identifier": "3853SY",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0213787",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.