Liljenquist Chiropractic, P.a.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH1A577 Issued in ID

Legal business name

LILJENQUIST CHIROPRACTIC, P.A.

Practice address

1700 Overland Avenue
Burley, ID 83318

Phone

(208) 678-2631

Fax

(208) 678-3334

NPI assigned

Mar 7, 2011

Organization subpart

No

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

Authorized official

Name

Cody S. Liljenquist, D.C.NPI 1356409445

Title

Owner/Chiropractor

Phone

(208) 678-2631

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 2

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

• Cody Shawn Liljenquist, D.C.

  • Orthopedic Chiropractor
  • Burley, ID
  • NPI 1356409445
  Medicare reassignment NPD Authorized official
• Cindy Hurst

  • Nurse Practitioner
  • Burley, ID
  • NPI 1265887319
  NPD (past)

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

{
    "created_epoch": "1299456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299456000000",
    "number": "1811295447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 OVERLAND AVENUE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "83318",
            "telephone_number": "208-678-2631",
            "fax_number": "208-678-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 OVERLAND AVENUE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "83318",
            "telephone_number": "208-678-2631",
            "fax_number": "208-678-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILJENQUIST CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-07",
        "last_updated": "2011-03-07",
        "status": "A",
        "authorized_official_last_name": "LILJENQUIST",
        "authorized_official_first_name": "CODY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "208-678-2631",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CH1A577",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "ID",
            "license": "ACC-78",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002663000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Andrew Larsen, D.D.S.
• Melissa Jo Larson, LPC
• LB Medical Consultants
• Leeana Hauser
• Nicholas Lewis, PT, DPT
• Cody Shawn Liljenquist, D.C.
• Archie Lynn Lilya
• Latoya Lott
• Janet B. Loveland, LCPC
• Magic Valley Pain Specialists, PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.