Mini-Cassia Chiropractic & Sports Medicine PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1817 Issued in ID

Legal business name

MINI-CASSIA CHIROPRACTIC & SPORTS MEDICINE PLLC

Practice address

749 N Overland Ave
Burley, ID 83318-3440

Phone

(208) 260-0917

Fax

(208) 391-2500

NPI assigned

Mar 26, 2018

Last updated

Sep 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jake W Sanford, DCNPI 1184125288

Title

Doctor

Phone

(208) 260-0917

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 1

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.

• Jake W Sanford, DC

  • Chiropractor
  • Burley, ID
  • NPI 1184125288
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725840000000",
    "number": "1942705546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 MACS AVE",
            "city": "HEYBURN",
            "state": "ID",
            "postal_code": "833369734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749 N OVERLAND AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833183440",
            "telephone_number": "208-260-0917",
            "fax_number": "208-391-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINI-CASSIA CHIROPRACTIC & SPORTS MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-26",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A",
        "authorized_official_last_name": "SANFORD",
        "authorized_official_first_name": "JAKE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "208-260-0917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis J Michaelson, DMD MS
• Bryce Wayne Millar, M.D.
• David Miller, DO
• Mini Cassia Counseling
• Mini-Cassia Care Center LLC
• Mini-Cassia Misdemeanor
• Mobile Drug Screen (Absolute Health Care)
• Monroe Anesthesia Services PC
• Matthew L Monroe, CRNA
• Rebecca Rae Morris, CNM WHNP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.