Eagle Sport & Family Chiropractic PLLC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

CHIA-1073 Issued in ID

Legal business name

EAGLE SPORT & FAMILY CHIROPRACTIC PLLC

Practice address

547 S Fitness PL
Suite 110
Eagle, ID 83616-6552

Phone

(208) 939-3986

Fax

(208) 319-2700

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Kraig K Knotts, D. C.NPI 1205883170

Title

Owner

Phone

(208) 939-3986

Specialties & licenses 1

Addresses

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.

• Kraig Kurtis Knotts, D.C.

  • Sports Physician Chiropractor
  • Eagle, ID
  • NPI 1205883170
  Medicare reassignment NPD Authorized official
• Corinne Patricia Bottrell, PH.D., N.D.

  • Cognitive & Behavioral Psychologist
  • Eagle, ID
  • NPI 1861039943
  NPD

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1861574410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 S FITNESS PL",
            "address_2": "SUITE 110",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166552",
            "telephone_number": "208-939-3986",
            "fax_number": "208-319-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 S FITNESS PL",
            "address_2": "SUITE 110",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166552",
            "telephone_number": "208-939-3986",
            "fax_number": "208-319-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE SPORT & FAMILY CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "KNOTTS",
        "authorized_official_first_name": "KRAIG",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-939-3986",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D. C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "ID",
            "license": "CHIA-1073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eagle Oral Surgery and Dental Implant Center PLLC
• Eagle Pediatrics,P.a.
• Eagle Physical Therapy PA
• Eagle River Dentistry
• Eagle River Psychiatry and Counseling
• Eagle Vision One PLLC
• Eagle Youth Counseling
• Lori Katherine Ebinger, PA-C
• Edge Counseling, LLC
• WKL Edgerly, COTA/L

• Sports Physician Chiropractor in Eagle, ID
• Providers in Eagle, ID by specialty
• Sports Physician Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.