Eagle Chiropractic PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

C561 Issued in ID

Legal business name

EAGLE CHIROPRACTIC PC

Practice address

5337 S State St
Eagle, ID 83616-4313

Phone

(208) 939-9195

Fax

(208) 939-4686

NPI assigned

Sep 25, 2006

Last updated

Oct 11, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

SHAWN NORDAs reported in NPPES

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

Authorized official

Name

Sherry Lynn Nord

Title

Secretary

Phone

(208) 939-9195

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Part of

Eagle Chiropractic PC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shawn Helmer Nord, D.C.

  • Chiropractor
  • Eagle, ID
  • NPI 1346232501
  Medicare reassignment NPD

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570752000000",
    "number": "1720188857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5337 W STATE ST",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836164313",
            "telephone_number": "208-939-9195",
            "fax_number": "208-939-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5337 S STATE ST",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836164313",
            "telephone_number": "208-939-9195",
            "fax_number": "208-939-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE CHIROPRACTIC PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHAWN NORD",
        "enumeration_date": "2006-09-25",
        "last_updated": "2019-10-11",
        "status": "A",
        "authorized_official_last_name": "NORD",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-939-9195"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ID",
            "license": "C561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebekah Dresback
• Diana Cristina Dumitrascu, M.D.
• Meghan Louise Dunnam, LPN
• Jacob Gary Dyer
• Aaron Dykstra, NP
• Eagle Cramer Chiropractic, P.a.
• Eagle Dental Partnership PLLC (Ascend Dental)
• Eagle Dermatology, PLLC
• Eagle Family Medicine P a
• Eagle Healthcare LLC

• Clinic/Center in Eagle, ID
• Providers in Eagle, ID by specialty
• Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2019; 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.