NPIMap

Organization Active NPI

Sawtooth Physical Therapy

  • Hand Occupational Therapist
  • Meridian, ID
National Provider Identifier
1003582040
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 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
Last updated
Nov 17, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
SAWTOOTH PHYSICAL THERAPY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XH1200X Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

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

Other NPIs with the same Medicare PAC ID 2

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

National Provider Directory

National Provider Directory
Tax ID family
Sawtooth Physical Therapy2 organizations share this tax ID, including this one
Part of
Sawtooth Physical Therapy

Other organizations with this tax ID 1

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

Locations

16816 N Marketplace Blvd
Nampa, ID 83687
Phone (208) 461-9593

Ownership & related parties

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.

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "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

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.