Individual provider Active NPI

Ronald Henze III, D.C.

  • Chiropractor
  • Boise, ID
National Provider Identifier
1932508272
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA1614 Issued in ID
Practice address
13999 W Wainwright Dr Ste 201
Boise, ID 83713-1969
Phone
(208) 939-0775
Fax
(208) 575-6114
NPI assigned
Aug 21, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIA1614 ID Primary

Addresses

Primary practice location

13999 W Wainwright Dr Ste 201
Boise, ID 83713-1969

Mailing address

13999 W Wainwright Dr Ste 201
Boise, ID 83713-1969
Phone (208) 939-0775

Other identifiers 1

IdentifierTypeStateIssuer
IDTPID012211MedicaidID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191223002355 MT Practitioner - Chiropractic 7012255953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Chiropractic PCGroup PAC ID 4688958549, 9 clinicians

Practice addresses (Care Compare)

780 Lola St
Helena, MT 59601-8682
Phone (406) 449-2501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA1614IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Chiropractic PLLC Chiropractor CurrentSince Oct 15, 2018 Accepting new patients
Balanced Chiropractic, PC Chiropractor CurrentSince Dec 1, 2019 Accepting new patients

Locations

13999 W Wainwright Dr
Ste 201
Boise, ID 83713
Phone (208) 939-0775

780 Lola St
Helena, MT 59601
Phone (406) 449-2501

800 Lola St
Helena, MT 59601
Phone (406) 449-2501

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1932508272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13999 W WAINWRIGHT DR STE 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131969",
            "telephone_number": "208-939-0775",
            "fax_number": "208-575-6114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13999 W WAINWRIGHT DR STE 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131969",
            "telephone_number": "208-939-0775",
            "fax_number": "208-575-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENZE",
        "first_name": "RONALD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-21",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA1614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IDTPID012211",
            "state": "ID"
        }
    ],
    "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 Nov 5, 2018; 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.