Organization Active NPI

Back Country Chiropractic and Wellness Center Inc.

  • Sports Physician Chiropractor
  • McCall, ID
National Provider Identifier
1861555286
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
CHIA578 Issued in ID
Legal business name
BACK COUNTRY CHIROPRACTIC AND WELLNESS CENTER INC.
Practice address
201 Park St.
McCall, ID 83638-1005
Phone
(208) 634-8129
Fax
(208) 634-7651
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Irwin Mulnick, D.C.NPI 1083737472
Title
President
Phone
(208) 634-8129

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internist ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NI0900X CHIA595 ID
Sports Physician ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NS0005X CHIA578 ID Primary

Addresses

Primary practice location

201 Park St.
McCall, ID 83638-1005

Mailing address

201 Park Street
PO Box 1005
McCall, ID 83638

Other identifiers 4

IdentifierTypeStateIssuer
C9446OtherIDBLUE CROSS, UMA MULNICK
CHIA578OtherIDIRWIN MULNICK LICENSE #
CHIA595OtherIDUMA MULNICK, LICENSE #
C5782OtherIDBLUE CROSS IRWIN MULNICK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101228000402 ID Part B Supplier - Clinic/Group Practice 5597953067 Receives reassigned benefits from 1 practitioner
Practice locations: McCall, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1861555286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK STREET",
            "address_2": "PO BOX 1005",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "83638",
            "fax_number": "208-634-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 PARK ST.",
            "city": "MCCALL",
            "state": "ID",
            "postal_code": "836381005",
            "telephone_number": "208-634-8129",
            "fax_number": "208-634-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK COUNTRY CHIROPRACTIC AND WELLNESS CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MULNICK",
        "authorized_official_first_name": "IRWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-634-8129",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NI0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Internist",
            "state": "ID",
            "license": "CHIA595",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "ID",
            "license": "CHIA578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS, UMA MULNICK",
            "identifier": "C9446",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRWIN MULNICK LICENSE #",
            "identifier": "CHIA578",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMA MULNICK, LICENSE #",
            "identifier": "CHIA595",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS IRWIN MULNICK",
            "identifier": "C5782",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McCall, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.