Individual provider Active NPI

Kurt A Bailey, DC, NP-C

  • Chiropractor
  • Lewiston, ID
National Provider Identifier
1528046661
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-810 Issued in ID
Practice address
3510 12TH St
Lewiston, ID 83501-5575
Phone
(208) 799-3333
Fax
(208) 799-3375
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-810 ID Primary
Chiropractor 111N00000X CH00003346 WA
Family Nurse Practitioner 363LF0000X NP-1087A ID

Addresses

Primary practice location

3510 12TH St
Lewiston, ID 83501-5575

Mailing address

3510 12TH St
Lewiston, ID 83501-5575
Phone (208) 799-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120124000519 ID Practitioner - ChiropracticPractitioner - Pain ManagementPractitioner - Family Practice 6406023951 Receives reassigned benefits from 1 practitioner
Practice locations: Lewiston, ID

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Family Practice, Pain Management
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3510 12TH St
Lewiston, ID 83501-5575

Hospital & facility affiliations

  • Gritman Medical Center Hospital, Moscow, ID, CCN 131327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH00003346WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lewiston Family Chiropractic Chiropractor PastSince Dec 1, 1996 Accepting new patients
Richard Cohen Professional Chiropractic Corporation Chiropractor Past Accepting new patients
Interventional Pain Consultants PA Past Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

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

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372204800000",
    "number": "1528046661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 12TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835015575",
            "telephone_number": "208-799-3333",
            "fax_number": "208-799-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 12TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835015575",
            "telephone_number": "208-799-3333",
            "fax_number": "208-799-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "KURT",
        "middle_name": "A",
        "credential": "DC, NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2013-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-810",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003346",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1087A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.