JACALYN RENAE AMRINE, D.C. — NPI 1003185265 (Licensed & Credentialed Chiropractic Providers

CMS-1500 Box 24J / 33a • NPI

1003185265

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

111N00000X (CMS 35)

Licensed & Credentialed Chiropractic Providers — Chiropractor

Box 32 Service Location & ZIP+4

435 E SHORE DR STE 130, EAGLE, ID, 83616-5754

✓ 9-Digit EDI 837 ZIP+4 (83616-5754)

Practice Phone & Referral Fax

(208) 917-1929

Fax: (208) 485-9629

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1003185265 (JACALYN RENAE AMRINE, D.C.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1003185265` (NPI-1 Individual Practitioner)
Provider / Legal Name	JACALYN RENAE AMRINE, D.C.
Plain-English Specialty	Licensed & Credentialed Chiropractic Providers — Chiropractor NUCC Code: `111N00000X` (Chiropractor)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	435 E SHORE DR STE 130, EAGLE, ID, 83616-5754
Practice Telephone / Fax	Tel: (208) 917-1929 \| Fax: (208) 485-9629
Administrative Mailing Address	435 E SHORE DR STE 130, EAGLE, ID, 83616-5754
Enumeration & Last Sync	Enumerated: 2011-12-17 \| CMS Record Updated: 2025-01-20

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

435 E SHORE DR STE 130, EAGLE, ID, 83616-5754

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Plain-English Taxonomy & CMS Crosswalk (111N00000X)

What Does Taxonomy Code 111N00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 111N00000X translates to:
"Licensed & Credentialed Chiropractic Providers — Chiropractor"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 35 (Chiropractic)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Chiropractor for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (JACALYN RENAE AMRINE, D.C.)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`111N00000X` — Chiropractor Plain English: Licensed & Credentialed Chiropractic Providers — Chiropractor	State: CA \| License: `32089` \| Primary: Secondary
`111N00000X` — Chiropractor Plain English: Licensed & Credentialed Chiropractic Providers — Chiropractor	State: ID \| License: `CHIA-1930` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JACALYN RENAE AMRINE, D.C. (NPI #1003185265)