NPIMap

Organization Active NPI

Manninen PLLC

Doing business as North Idaho Spine Clinic

  • Chiropractor
  • Sandpoint, ID
National Provider Identifier
1679197198
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MANNINEN PLLC
Doing business as
North Idaho Spine Clinic
Practice address
1207 Michigan St Ste B
Sandpoint, ID 83864-6608
Phone
(208) 265-2225
NPI assigned
Jun 1, 2020
Last updated
Jun 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Authorized official

Name
Dr. Adam James Manninen, DCNPI 1225344724
Title
Member
Phone
(406) 548-7562

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
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

1207 Michigan St Ste B
Sandpoint, ID 83864-6608

Mailing address

17754 Cherokee Dr
Spring Lake, MI 49456-9404
Phone (406) 548-7562

Other names 1

  • North Idaho Spine Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200624001812 ID Part B Supplier - Clinic/Group Practice 8224450010 Receives reassigned benefits from 1 practitioner
Practice locations: Sandpoint, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1590969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590969600000",
    "number": "1679197198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17754 CHEROKEE DR",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569404",
            "telephone_number": "406-548-7562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 MICHIGAN ST STE B",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838646608",
            "telephone_number": "208-265-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANNINEN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-01",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A",
        "authorized_official_last_name": "MANNINEN",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "406-548-7562",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Idaho Spine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sandpoint, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2020; 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.