Moldenhauer Chiropractic Center PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA296 Issued in ID

Legal business name

MOLDENHAUER CHIROPRACTIC CENTER PC

Practice address

228 Holly St
Nampa, ID 83686-5104

Phone

(208) 467-5759

Fax

(208) 467-4510

NPI assigned

Sep 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Glenn W Moldenhauer, D.C.

Title

Owner

Phone

(208) 467-5759

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237161600000",
    "number": "1942497532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 HOLLY ST",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836865104",
            "telephone_number": "208-467-5759",
            "fax_number": "208-467-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 HOLLY ST",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836865104",
            "telephone_number": "208-467-5759",
            "fax_number": "208-467-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLDENHAUER CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2009-03-16",
        "status": "A",
        "authorized_official_last_name": "MOLDENHAUER",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-467-5759",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CK7825",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002554100",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "C9420",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010008275",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Nampa, ID
• Providers in Nampa, ID by specialty
• Chiropractor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; 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.