Active NPI
Spinal DRS Inc.
Doing business as Spinal Dynamics Chiropractic
- Rehabilitation Chiropractor
- Meridian, ID
National Provider Identifier
1558728592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- CHIA 968
- Legal business name
- SPINAL DRS INC.
- Doing business as
- Spinal Dynamics Chiropractic
- Practice address
- 3715 E Overland Rd
Unit 105
Meridian, ID 83642-8301 - Phone
- (208) 888-0055
- Fax
- (208) 888-5062
- NPI assigned
- Jan 21, 2016
- Last updated
- Jan 21, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jamie Matthew Ricks, D.C.
- Title
- President
- Phone
- (208) 841-3564
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 |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | CHIA 968 | ID | Primary |
Addresses
Primary practice location
3715 E Overland Rd
Unit 105
Meridian, ID 83642-8301
Mailing address
3715 E Overland Rd
Unit 105
Meridian, ID 83642-8301
Phone (208) 888-0055
Other names 1
- Spinal Dynamics Chiropractic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 4
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.
-
- Chiropractor
- Boise, ID
- NPI 1053379610
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453334400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1453334400000",
"number": "1558728592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3715 E OVERLAND RD",
"address_2": "UNIT 105",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836428301",
"telephone_number": "208-888-0055",
"fax_number": "208-888-5062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3715 E OVERLAND RD",
"address_2": "UNIT 105",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836428301",
"telephone_number": "208-888-0055",
"fax_number": "208-888-5062"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPINAL DRS INC.",
"organizational_subpart": "NO",
"enumeration_date": "2016-01-21",
"last_updated": "2016-01-21",
"status": "A",
"authorized_official_last_name": "RICKS",
"authorized_official_first_name": "JAMIE",
"authorized_official_middle_name": "MATTHEW",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "208-841-3564",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor, Rehabilitation",
"state": "ID",
"license": "CHIA 968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Spinal Dynamics Chiropractic",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; 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.