Jeremy J Boethin, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-2246 Issued in ID

Practice address

12545 W Goldcrest St
Star, ID 83669-6513

Phone

(541) 480-1555

NPI assigned

Mar 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR, ID2 enrollments

Enrollment records 2

Specialty

Chiropractic

Education

Western States College of Chiropractic, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Elevate Chiropractic

  • Chiropractor
  • Star, ID
  • NPI 1457138539
  Medicare reassignment NPD Authorized official
• Point Chiropractic PC

  • Chiropractor
  • Bend, OR
  • NPI 1912155870
  Medicare reassignment NPD
• Discover Chiropractic, P.C.

  • Chiropractor
  • Bend, OR
  • NPI 1801344940
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1740314442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12545 W GOLDCREST ST",
            "city": "STAR",
            "state": "ID",
            "postal_code": "836696513",
            "telephone_number": "541-480-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12545 W GOLDCREST ST",
            "city": "STAR",
            "state": "ID",
            "postal_code": "836696513",
            "telephone_number": "541-480-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOETHIN",
        "first_name": "JEREMY",
        "middle_name": "J",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "273407",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-2246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chad Sterling Barton, LMFT
• Beverlee K Furner, NP PLLC
• Douglas Birkland
• Rachel Raelene Bobst, MS, LPC
• Sarah Bodily, OTR/L
• Boise River Physical Therapy
• Matthew Bolen
• Kari Lynne Bouffard-Cheng
• Katherine Gail Buracchio, APRN, PMHNP-BC
• Debra Dee Cammann

• Chiropractor in Star, ID
• Providers in Star, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.