Individual provider Active NPI

Wade Summers, D.C.

  • Chiropractor
  • Meridian, ID
National Provider Identifier
1689031080
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1703 Issued in ID
Practice address
2857 S Meridian Rd Ste 100
Meridian, ID 83642-7960
Phone
(208) 888-5858
NPI assigned
Jan 15, 2016
Last updated
Oct 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA-1703 ID Primary

Addresses

Primary practice location

2857 S Meridian Rd Ste 100
Meridian, ID 83642-7960

Mailing address

2857 S Meridian Rd Ste 100
Meridian, ID 83642-7960
Phone (208) 888-5858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-1703IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
After Hours Chiropractic Care Chiropractor Current Accepting new patients
Meridian Chiropractic Clinic LLC Chiropractor CurrentSince Aug 20, 2022 Accepting new patients
Enso Chiropractic PLLC Chiropractor PastSince Feb 15, 2016 Accepting new patients

Locations

2857 S Meridian Rd
#100
Meridian, ID 83642
Phone (208) 639-7300

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1689031080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2857 S MERIDIAN RD STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427960",
            "telephone_number": "208-888-5858",
            "fax_number": "208-884-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2857 S MERIDIAN RD STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427960",
            "telephone_number": "208-888-5858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-15",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.