JUSTIN MICHAEL ANDERSON, DC — NPI 1245694041 (Licensed & Credentialed Chiropractic Providers

CMS-1500 Box 24J / 33a • NPI

1245694041

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

111N00000X (CMS 35)

Licensed & Credentialed Chiropractic Providers — Chiropractor

Box 32 Service Location & ZIP+4

6744 N GLENWOOD ST, BOISE, ID, 83714-1926

✓ 9-Digit EDI 837 ZIP+4 (83714-1926)

Practice Phone & Referral Fax

(712) 899-8984

Direct NPPES Verification Line

⚠️ HHS OIG LEIE FEDERAL EXCLUSION ALERT: NPI 1245694041 matches an active entry in the HHS Office of Inspector General List of Excluded Individuals/Entities (Sec. 1128(a)(2) — Conviction Relating to Patient Abuse or Neglect — Effective 2024-06-20). Verify before submitting Medicare/Medicaid claims.

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	`1245694041` (NPI-1 Individual Practitioner)
Provider / Legal Name	JUSTIN MICHAEL ANDERSON, DC
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	6744 N GLENWOOD ST, BOISE, ID, 83714-1926
Practice Telephone / Fax	Tel: (712) 899-8984
Administrative Mailing Address	6744 N GLENWOOD ST, BOISE, ID, 83714-1926
Enumeration & Last Sync	Enumerated: 2016-04-07 \| CMS Record Updated: 2021-02-07

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

6744 N GLENWOOD ST, BOISE, ID, 83714-1926

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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 (JUSTIN MICHAEL ANDERSON, DC)

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
`111NR0400X` — Chiropractor, Rehabilitation Plain English: Licensed & Credentialed Chiropractic Providers — Chiropractor, Rehabilitation	State: ID \| License: `CHIA-1675` \| Primary: Secondary
`111N00000X` — Chiropractor Plain English: Licensed & Credentialed Chiropractic Providers — Chiropractor	State: ID \| License: `CHIA-1675` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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JUSTIN MICHAEL ANDERSON, DC (NPI #1245694041)