Individual provider Active NPI

F. Blake Ambridge, DC.,DACNB

  • Neurology Chiropractor
  • Sandpoint, ID
National Provider Identifier
1699726398
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
19037 Issued in CA
Practice address
1327 W Superior St Ste 103
Sandpoint, ID 83864-2742
Phone
(208) 946-5888
Fax
(208) 920-6004
NPI assigned
May 15, 2006
Last updated
May 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X CHIA-1724 ID
Neurology Chiropractor 111NN0400X CH61009706 WA
Neurology Chiropractor 111NN0400X 19037 CA Primary

Addresses

Primary practice location

1327 W Superior St Ste 103
Sandpoint, ID 83864-2742

Mailing address

1327 W Superior St Ste 103
Sandpoint, ID 83864-2742
Phone (208) 946-5888

Other practice location 1

1113 E Westview Ct
Spokane, WA 99218-1319
Phone (208) 946-5888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200904001053 ID Practitioner - Chiropractic 0042278715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1987
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1327 W Superior St
Suite 103
Sandpoint, ID 83864-2742
Phone (208) 946-5888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-1724IDMDNeurology Chiropractor
CH61009706WAMDNeurology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ambridge Chiropractic Neurology PC CurrentSince Feb 5, 2020 Accepting new patients
True North Wellness Center Current Accepting new patients

Locations

1327 W Superior St
Ste 103
Sandpoint, ID 83864
Phone (208) 946-5888

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1699726398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 W SUPERIOR ST STE 103",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838642742",
            "telephone_number": "208-946-5888",
            "fax_number": "208-920-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 W SUPERIOR ST STE 103",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838642742",
            "telephone_number": "208-946-5888",
            "fax_number": "208-920-6004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1113 E Westview Ct",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992181319",
            "country_code": "US",
            "telephone_number": "208-946-5888",
            "fax_number": "208-920-6004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMBRIDGE",
        "first_name": "F.",
        "middle_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "DC.,DACNB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "ID",
            "license": "CHIA-1724",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "WA",
            "license": "CH61009706",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "CA",
            "license": "19037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 19, 2020; 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.

Verify at the official NPI Registry.