Active NPI
Dillon Jade Michael, DC
- Chiropractor
- Eagle, ID
National Provider Identifier
1619737335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2171641
- Practice address
- 1299 E Iron Eagle Dr Ste 130
Eagle, ID 83616-6869 - Phone
- (208) 582-3421
- NPI assigned
- Mar 20, 2024
- Last updated
- Apr 9, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2171641 | ID | Primary |
Addresses
Primary practice location
1299 E Iron Eagle Dr Ste 130
Eagle, ID 83616-6869
Mailing address
1500 S Lamar Blvd Apt 3057
Austin, TX 78704-2949
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250611003138 | ID | Practitioner - Chiropractic | 4385154913 | Practice locations: Eagle, ID |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1299 E Iron Eagle Dr
Suite 130
Eagle, ID 83616-6599
Phone (208) 922-6612
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2171641 | ID | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael Wellness Ventures PLLC | Chiropractor | Current | Accepting new patients |
| Cedar Park Chiropractic Clinic, Inc. | Chiropractor | Past | Accepting new patients |
Locations
1299 E Iron Eagle Dr
Ste 130
Eagle, ID 83616
Phone (208) 922-6612
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Eagle, ID
- NPI 1952196438
-
- Chiropractor
- Cedar Park, TX
- NPI 1083730303
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744156800000",
"number": "1619737335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 S LAMAR BLVD APT 3057",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787042949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1299 E IRON EAGLE DR STE 130",
"city": "EAGLE",
"state": "ID",
"postal_code": "836166869",
"telephone_number": "208-582-3421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAEL",
"first_name": "DILLON",
"middle_name": "JADE",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-20",
"last_updated": "2025-04-09",
"certification_date": "2025-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ID",
"license": "2171641",
"primary": true
}
],
"identifiers": [],
"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 Apr 9, 2025; 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.