Jacob Bower

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

CHIA-1618 Issued in ID

Practice address

1601 12TH Ave Rd
Suite 101
Nampa, ID 83686-5015

Phone

(208) 466-0200

Fax

(208) 621-3140

NPI assigned

Jan 29, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

ChiropracticAlso: Sports Medicine

Education

Palmer College Chiropractic - West Sunnyvale, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime Sports MedGroup PAC ID 9638587801, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prime Sports Med

  • Chiropractor
  • Nampa, ID
  • NPI 1407354574
  Medicare reassignment Care Compare group NPD Authorized official
• Stephen W Smith Chiropractic Inc

  • Chiropractor
  • Buena Park, CA
  • NPI 1396763090

  Sports Physician

  NPD

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

{
    "created_epoch": "1454025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1891153391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 12TH AVE RD",
            "address_2": "SUITE 101",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836865015",
            "telephone_number": "208-466-0200",
            "fax_number": "208-621-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 12TH AVE RD",
            "address_2": "SUITE 101",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836865015",
            "telephone_number": "208-466-0200",
            "fax_number": "208-621-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWER",
        "first_name": "JACOB",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-01-29",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "ID",
            "license": "CHIA-1618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Boorman, PT, DPT
• Emily A Border, PA-C
• Tina Monique Bossolono-Williams
• Jennifer Dean Boston, LPC
• Bower Chiropractic Inc
• Jonathan Leslie Bowman, MD
• Patricia Ann Bowman, LMSW
• John Boyajian, MD
• Boyd Counseling Services, LLC
• Alli Renee Boyd

• Sports Physician Chiropractor in Nampa, ID
• Providers in Nampa, 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 May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.