Organization Active NPI

Michael Wellness Ventures PLLC

  • Chiropractor
  • Eagle, ID
National Provider Identifier
1952196438
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MICHAEL WELLNESS VENTURES PLLC
Practice address
1299 E Iron Eagle Dr Ste 130
Eagle, ID 83616-6869
Phone
(208) 582-3421
NPI assigned
Apr 14, 2025
Last updated
Apr 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Authorized official

Name
Dillon Jade Michael, DCNPI 1619737335
Title
Chiropractor
Phone
(208) 582-3421

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1299 E Iron Eagle Dr Ste 130
Eagle, ID 83616-6869

Mailing address

7071 W Belhaven Dr
Boise, ID 83714-2477

National Provider Directory

National Provider Directory

Locations

1299 E Iron Eagle Dr
Ste 130
Eagle, ID 83616
Phone (208) 922-6612

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1952196438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7071 W BELHAVEN DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837142477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1299 E IRON EAGLE DR STE 130",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166869",
            "telephone_number": "208-582-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL WELLNESS VENTURES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "DILLON",
        "authorized_official_middle_name": "JADE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "208-582-3421",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; 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.