NPIMap

Organization Active NPI

Highland Chiropractic PLLC

  • Chiropractor
  • Boise, ID
National Provider Identifier
1548514409
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1518 Issued in ID
Legal business name
HIGHLAND CHIROPRACTIC PLLC
Practice address
13999 W Wainwright Dr Ste 201
Boise, ID 83713-1967
Phone
(208) 939-0775
Fax
(208) 301-5004
NPI assigned
Oct 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Authorized official

Name
Matthew Ogle, DCNPI 1730439100
Title
Owner
Phone
(208) 939-0775

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 CHIA-1518 ID Primary

Addresses

Primary practice location

13999 W Wainwright Dr Ste 201
Boise, ID 83713-1967

Mailing address

13999 W Wainwright Dr Ste 201
Boise, ID 83713-1967
Phone (208) 939-0775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150129001277 ID Part B Supplier - Clinic/Group Practice 6406170125 Receives reassigned benefits from 3 practitioners
Practice locations: Boise, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1548514409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13999 W WAINWRIGHT DR STE 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131967",
            "telephone_number": "208-939-0775",
            "fax_number": "208-301-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13999 W WAINWRIGHT DR STE 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131967",
            "telephone_number": "208-939-0775",
            "fax_number": "208-301-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A",
        "authorized_official_last_name": "OGLE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-939-0775",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.

Verify at the official NPI Registry.