NPIMap

Organization Active NPI

Pickman Chiropractic Inc.

Doing business as Gonstead Spine & Wellness

  • Chiropractor
  • Meridian, ID
National Provider Identifier
1912324856
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA1516 Issued in ID
Legal business name
PICKMAN CHIROPRACTIC INC.
Doing business as
Gonstead Spine & Wellness
Practice address
3085 E Magic View Dr Ste 180
Meridian, ID 83642
Phone
(208) 888-6077
Fax
(888) 447-1415
NPI assigned
Mar 27, 2014
Last updated
Jul 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Authorized official

Name
Dr. Todd Pickman, D.C.NPI 1013018282
Title
Business Owner/Dr
Phone
(208) 888-6077

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA1516 ID Primary

Addresses

Primary practice location

3085 E Magic View Dr Ste 180
Meridian, ID 83642

Mailing address

3085 E Magic View Dr Ste 180
Meridian, ID 83642
Phone (208) 888-6077

Other names 1

  • GONSTEAD SPINE & WELLNESS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140612001137 ID Part B Supplier - Clinic/Group Practice 7810111879 Receives reassigned benefits from 4 practitioners
Practice locations: Meridian, ID

National Provider Directory

National Provider Directory

Locations

1551 W Cherry Ln
Ste 105
Meridian, ID 83642
Phone (208) 888-6077

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1912324856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 E MAGIC VIEW DR STE 180",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-888-6077",
            "fax_number": "888-447-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 E MAGIC VIEW DR STE 180",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-888-6077",
            "fax_number": "888-447-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICKMAN CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-27",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "PICKMAN",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "BUSINESS OWNER/DR",
        "authorized_official_telephone_number": "208-888-6077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA1516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GONSTEAD SPINE & WELLNESS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GONSTEAD SPINE & WELLNESS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.