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DR. KENNETH ALAN GOUGH DC
NPI 1285966598
Chiropractor in Boise, ID

Active since February 11, 2010
3040 N FIVE MILE RD, SUITE C, BOISE, ID 83713(208) 324-8484(208) 321-5084 Get Directions Write a Review

NPPES record last updated: April 25, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Kenneth Alan Gough Dc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENNETH ALAN GOUGH DC (NPI 1285966598) is an individual chiropractor in Boise, Idaho, licensed in Idaho (CHIA-1501) and active in the NPI registry since February 2010.

NPPES Registry Identity

NPI1285966598
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameDR. KENNETH ALAN GOUGHCredential: DC
Location Address3040 N FIVE MILE RD, SUITE CBoise, ID 83713-5234
Mailing Address3040 N Five Mile Rd, Suite CBoise, ID 83713-5234 · (208) 324-8484 · Fax (208) 321-5084
Phone(208) 324-8484
Fax(208) 321-5084
Sole ProprietorYes
Enumeration DateFebruary 11, 2010
Last NPPES UpdateApril 25, 2012
✔ NPI 1285966598 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
Licenses✔ Licensed in ID · CHIA-1501✔ Licensed in OR · 3994
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
3040 N FIVE MILE RD, Boise, ID 83713
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kenneth Alan Gough Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Kenneth Gough reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Quick Recovery Chiropractic PLLC
9.8 mi
Chiropractor
6705 JOE LN
Nampa, ID 83687
  • Reassigned Medicare billing, Idaho enrollment
NPI 1245718170 (208) 319-6340

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LUKE A. WILLETT D.C.
Chiropractor
3040 N FIVE MILE RD, SUITE C
BOISE, ID 83713
Ada County (208) 321-8484
COLLIN LARSON
Physical Therapist
3040 N FIVE MILE RD
BOISE, ID 83713
Ada County (208) 939-0533
SYDNEY STEEN
Behavior Technician
3040 N FIVE MILE RD
BOISE, ID 83713
Ada County (208) 252-6531
CODY ANDERSON DPT
Physical Therapist
3040 N FIVE MILE RD
BOISE, ID 83713
Ada County (208) 939-0533
PRO MOTION PHYSICAL THERAPY LLC
Physical Therapist (Orthopedic)
3040 N FIVE MILE RD
BOISE, ID 83713
Ada County (208) 336-1042
CHRISTOPHER GEORGE OLSHAVSKY DPT
Physical Therapist
3040 N FIVE MILE RD
BOISE, ID 83713
Ada County (208) 939-0533
ELISE MORROW
Physical Therapist
3040 N FIVE MILE RD
BOISE, ID 83713
Ada County (208) 939-0533
JORDAN NOEL STEICHEN
Physical Therapist
3040 N FIVE MILE RD
BOISE, ID 83713
Ada County (208) 939-0533

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Gough's NPI number?

The NPI number for Kenneth Gough is 1285966598. It was assigned to this individual provider in the NPPES registry on February 11, 2010.

Where is Kenneth Gough located?

Kenneth Gough practices at 3040 N Five Mile Rd Suite C, Boise, ID 83713. The listed phone number is (208) 324-8484.

What is Kenneth Gough's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Kenneth Gough enrolled in Medicare?

Yes. Kenneth Gough is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kenneth Gough's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Gough reassigns Medicare benefits to Quick Recovery Chiropractic PLLC (Nampa, ID). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenneth Gough's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kenneth Gough was last updated on April 25, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.