Grand Teton Chiropractic, P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA 904 Issued in ID

Legal business name

GRAND TETON CHIROPRACTIC, P.C.

Practice address

1220 E 17TH St
Idaho Falls, ID 83404-6147

Phone

(208) 529-1919

Fax

(208) 552-9447

NPI assigned

Jun 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. James C. Gardner, D.C.NPI 1821036856

Title

President

Phone

(208) 529-1919

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

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

• James Criddle Gardner, D.C.

  • Chiropractor
  • Idaho Falls, ID
  • NPI 1821036856
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1679519193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4317 AMBER LN",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834064640",
            "telephone_number": "208-542-9567",
            "fax_number": "208-552-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046147",
            "telephone_number": "208-529-1919",
            "fax_number": "208-552-9447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND TETON CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-529-1919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA 904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylee Louise Gould
• Steele Gould
• Sara Graham, RN
• Zebulon C Graham, PHARMD
• Grand Teton Child Neurology
• Grand Teton Chiropractic, PLLC
• Grand Teton Gastroenterology
• Grand Teton Gastroenterology, PA
• Grand Teton Service Group
• Grand Teton Service Group

• Chiropractor in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; 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.