Active NPI
Andrew Charles Kidder, DC
- Chiropractor
- Boise, ID
National Provider Identifier
1710048681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIA-1137
- Practice address
- 3211 N Milwaukee St
Boise, ID 83704-4446 - Phone
- (208) 375-2225
- Fax
- (208) 375-2276
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIA-1137 | ID | Primary |
Addresses
Primary practice location
3211 N Milwaukee St
Boise, ID 83704-4446
Mailing address
3211 N Milwaukee St
Boise, ID 83704-4446
Phone (208) 375-2225
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
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA-1137 | ID | MD | Chiropractor |
| 971 | NV | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Awic, P.C. | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710048681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3211 N MILWAUKEE ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837044446",
"telephone_number": "208-375-2225",
"fax_number": "208-375-2276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3211 N MILWAUKEE ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837044446",
"telephone_number": "208-375-2225",
"fax_number": "208-375-2276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDDER",
"first_name": "ANDREW",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ID",
"license": "CHIA-1137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.