Jeppe Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1048 Issued in ID

Legal business name

JEPPE CHIROPRACTIC PLLC

Practice address

4491 N Dresden PL Ste 3
Garden City, ID 83714-1391

Phone

(208) 378-1190

Fax

(208) 323-6508

NPI assigned

Nov 12, 2007

Last updated

Nov 12, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Benjamin E Jeppe, D.C.

Title

Chiropractor/Owner

Phone

(208) 378-1190

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194825600000",
    "number": "1861672446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4491 N DRESDEN PL STE 3",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837141391",
            "telephone_number": "208-378-1190",
            "fax_number": "208-323-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4491 N DRESDEN PL STE 3",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837141391",
            "telephone_number": "208-378-1190",
            "fax_number": "208-323-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEPPE CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-12",
        "last_updated": "2007-11-12",
        "status": "A",
        "authorized_official_last_name": "JEPPE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "208-378-1190",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.