Dr. Mick L. Tiegs, Inc., PS

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

CHIA-1056 Issued in ID

Legal business name

DR. MICK L. TIEGS, INC., PS

Practice address

2301 N 36TH St
Boise, ID 83703-5207

Phone

(208) 571-8418

Fax

(208) 344-5277

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mick L. Tiegs, D.C.NPI 1497750350

Title

Doctor of Chiropractic

Phone

(208) 571-8418

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Northside Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 2

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

• Mick L. Tiegs, D.C.

  • Chiropractor
  • Seattle, WA
  • NPI 1497750350

  ID

  Medicare reassignment Care Compare group NPD Authorized official
• William Kevin Davis, DC

  • Chiropractor
  • Campbell, CA
  • NPI 1144398389

  ID

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202083200000",
    "number": "1689709735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 N 36TH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837035207",
            "telephone_number": "208-571-8418",
            "fax_number": "208-344-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 N 36TH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837035207",
            "telephone_number": "208-571-8418",
            "fax_number": "208-344-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MICK L. TIEGS, INC., PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-02-04",
        "status": "A",
        "authorized_official_last_name": "TIEGS",
        "authorized_official_first_name": "MICK",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "208-571-8418",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "3119",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "ID",
            "license": "CHIA-1056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-INDIVIDUAL",
            "identifier": "1497750350",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northside Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Health Service Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Health Service Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; 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.