Active NPI
Jordan Robertson, D.C.
- Chiropractor
- Boise, ID
National Provider Identifier
1861038895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIA-1973
- Practice address
- 6200 N Meeker PL Ste 220
Boise, ID 83713-1891 - Phone
- (208) 994-2931
- NPI assigned
- Nov 25, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIA-1973 | ID | Primary |
Addresses
Primary practice location
6200 N Meeker PL Ste 220
Boise, ID 83713-1891
Mailing address
6200 N Meeker PL Ste 220
Boise, ID 83713-1891
Phone (208) 994-2931
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA-1973 | ID | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715731200000",
"number": "1861038895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6200 N MEEKER PL STE 220",
"city": "BOISE",
"state": "ID",
"postal_code": "837131891",
"telephone_number": "208-994-2931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6200 N MEEKER PL STE 220",
"city": "BOISE",
"state": "ID",
"postal_code": "837131891",
"telephone_number": "208-994-2931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "JORDAN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-25",
"last_updated": "2024-05-15",
"certification_date": "2024-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ID",
"license": "CHIA-1973",
"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 May 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.