NPIMap

Organization Active NPI

Chiropractic Pain Relief Clinic P a

Doing business as Priebe Chiropractic

  • Chiropractor
  • Hayden, ID
National Provider Identifier
1821024134
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-856 Issued in ID
Legal business name
CHIROPRACTIC PAIN RELIEF CLINIC P A
Doing business as
Priebe Chiropractic
Practice address
8109 N Wayne Blvd
Hayden, ID 83835-5031
Phone
(208) 667-7463
Fax
(208) 762-6385
NPI assigned
Jun 26, 2006
Last updated
Oct 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Authorized official

Name
Mr. Randall P Priebe, D.C.NPI 1427003532
Title
Owner
Phone
(208) 667-7463

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
Chiropractor 111N00000X CHIA-856 ID Primary

Addresses

Primary practice location

8109 N Wayne Blvd
Hayden, ID 83835-5031

Mailing address

8109 N Wayne Blvd
Hayden, ID 83835-5031
Phone (208) 667-7463

Other practice location 1

850 W Ironwood Dr Ste 104
Coeur D Alene, ID 83814-4903
Phone (208) 664-5225

Other identifiers 1

IdentifierTypeStateIssuer
805124000MedicaidID

Other names 1

  • Priebe Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415001211 ID Part B Supplier - Clinic/Group Practice 0547255945 Receives reassigned benefits from 3 practitioners
Practice locations: Coeur D Alene, ID; Hayden, ID

National Provider Directory

National Provider Directory
Tax ID family
Chiropractic Pain Relief Clinic P a2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2025 W Park Pl
#B
Coeur D Alene, ID 83814
Phone (208) 620-5210

850 W Ironwood Dr
Ste 104
Coeur D Alene, ID 83814
Phone (208) 664-5225

8109 N Wayne Dr
Hayden, ID 83835
Phone (208) 664-5225

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1821024134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8109 N WAYNE BLVD",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838355031",
            "telephone_number": "208-667-7463",
            "fax_number": "208-762-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8109 N WAYNE BLVD",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838355031",
            "telephone_number": "208-667-7463",
            "fax_number": "208-762-6385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 W Ironwood Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838144903",
            "country_code": "US",
            "telephone_number": "208-664-5225",
            "fax_number": "208-664-5228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHIROPRACTIC PAIN RELIEF CLINIC P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A",
        "authorized_official_last_name": "PRIEBE",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-667-7463",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805124000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Priebe Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hayden, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.