Individual provider Active NPI

Michael T Henze, D.C.

  • Chiropractor
  • Boise, ID
National Provider Identifier
1902008246
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
9211 W Overland Rd
Boise, ID 83709-2502
Phone
(208) 377-7970
Fax
(208) 377-0796
NPI assigned
May 31, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X ID Primary

Addresses

Primary practice location

9211 W Overland Rd
Boise, ID 83709-2502

Mailing address

9211 W Overland Rd
Boise, ID 83709-2502
Phone (208) 377-7970

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040820000324 ID Practitioner - Chiropractic 7810961430

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9211 W Overland Rd
Boise, ID 83709-2502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
185511300IDMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902008246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9211 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837092502",
            "telephone_number": "208-377-7970",
            "fax_number": "208-377-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9211 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837092502",
            "telephone_number": "208-377-7970",
            "fax_number": "208-377-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENZE",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": null,
            "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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.