NPIMap

Sawtooth Physical Therapy

Organization Active NPI Hand Occupational Therapist · Meridian, ID

NPI 1003582040 · NPPES record last updated Nov 17, 2022

Key facts

NPI
1003582040
Entity type
Organization (NPI type 2)
Primary specialty
Hand Occupational Therapist 225XH1200X
Legal business name
SAWTOOTH PHYSICAL THERAPY
Practice address
4842 N Cortona Way Ste 100
Meridian, ID 83646-3171
Phone
(208) 888-8302
NPI assigned
Aug 19, 2021
Organization subpart
Yes
Parent organization (as reported)
SAWTOOTH PHYSICAL THERAPY LLC

Authorized official

Name
Gina Mulkey
Title
Office Manager
Phone
(208) 887-3498

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ID

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230113002149 ID DME Supplier - Independently-Practicing Occupational Therapist 1759552961 Practice locations: Meridian, ID

National Provider Directory

Tax ID family
Sawtooth Physical Therapy (2 organizations share this tax ID)
Part of
Sawtooth Physical Therapy

Locations

3015 E Magic View Dr
Ste 100
Meridian, ID 83642
Phone (208) 887-3498

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225XH1200X Yes

Addresses

Primary practice location

4842 N Cortona Way Ste 100
Meridian, ID 83646-3171

Mailing address

7979 W Rifleman St Ste 200
Boise, ID 83704-9066
Phone (208) 377-3850

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 17, 2022.

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1003582040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7979 W RIFLEMAN ST STE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049066",
            "telephone_number": "208-377-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4842 N CORTONA WAY STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836463171",
            "telephone_number": "208-888-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAWTOOTH PHYSICAL THERAPY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAWTOOTH PHYSICAL THERAPY LLC",
        "enumeration_date": "2021-08-19",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "MULKEY",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-887-3498"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

All providers in Meridian, ID · Hand Occupational Therapist in Idaho

Sources for this page

Verify at the official NPI Registry.