Individual provider Active NPI

Kimball T. Lundahl, D.C.

  • Chiropractor
  • Meridian, ID
National Provider Identifier
1760598478
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-1089 Issued in ID
Practice address
14 S Baltic PL
Meridian, ID 83642-5935
Phone
(208) 887-4872
Fax
(208) 887-6331
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 2671299 ID
Chiropractor 111N00000X CHIA-1089 ID Primary

Addresses

Primary practice location

14 S Baltic PL
Meridian, ID 83642-5935

Mailing address

14 S Baltic PL
Meridian, ID 83642-5935
Phone (208) 887-4872

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090309000208 ID Practitioner - Chiropractic 5092613752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthy Habits Wellness Clinic IncGroup PAC ID 6406912997, 2 clinicians

Practice addresses (Care Compare)

14 S Baltic PL
Meridian, ID 83642-5935
Phone (208) 887-4872

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-1089IDMDChiropractor

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1760598478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 S BALTIC PL",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425935",
            "telephone_number": "208-887-4872",
            "fax_number": "208-887-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S BALTIC PL",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425935",
            "telephone_number": "208-887-4872",
            "fax_number": "208-887-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDAHL",
        "first_name": "KIMBALL",
        "middle_name": "T.",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "ID",
            "license": "2671299",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.