Organization Active NPI

Crum Chiropractic, LLC

  • Chiropractor
  • Boise, ID
National Provider Identifier
1740458199
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1099 Issued in ID
Legal business name
CRUM CHIROPRACTIC, LLC
Practice address
1390 South Maple Grove Road
Suite 200
Boise, ID 83709
Phone
(208) 672-0100
NPI assigned
Feb 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Authorized official

Name
Eric Crum, DC, MPHNPI 1346259520
Title
Owner
Phone
(208) 672-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIA-1099 ID Primary

Addresses

Primary practice location

1390 South Maple Grove Road
Suite 200
Boise, ID 83709

Mailing address

1390 South Maple Grove Road
Suite 200
Boise, ID 83709

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080320000709 ID Part B Supplier - Clinic/Group Practice 4981780616 Receives reassigned benefits from 1 practitioner
Practice locations: Boise, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314057600000",
    "number": "1740458199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 SOUTH MAPLE GROVE ROAD",
            "address_2": "SUITE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 SOUTH MAPLE GROVE ROAD",
            "address_2": "SUITE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83709",
            "telephone_number": "208-672-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRUM CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2011-08-23",
        "status": "A",
        "authorized_official_last_name": "CRUM",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-672-0100",
        "authorized_official_credential": "DC, MPH"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1099",
            "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 Aug 23, 2011; 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.