NPIMap

Organization Active NPI

Sawtooth Physical Therapy

  • Physical Therapy Clinic/Center
  • Boise, ID
National Provider Identifier
1013206002
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT 1938 Issued in ID
Legal business name
SAWTOOTH PHYSICAL THERAPY
Practice address
7979 W Rifleman St Ste 200
Boise, ID 83704-9066
Phone
(208) 340-5099
NPI assigned
Mar 31, 2011
Last updated
Jun 11, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Authorized official

Name
Ronald D Miller Jr., PT MS OCSNPI 1952352601
Title
President
Phone
(208) 340-5099

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X PT 1938 ID Primary

Addresses

Primary practice location

7979 W Rifleman St Ste 200
Boise, ID 83704-9066

Mailing address

235 Flume St
Boise, ID 83712-6318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110920000507 ID Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1759552961 Receives reassigned benefits from 31 practitioners
Practice locations: Boise, ID; Nampa, ID; Meridian, ID
O20200615002647 ID DME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Independently-Practicing Physical Therapist 1759552961 Practice locations: Boise, 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

Other organizations with this tax ID 1

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

Locations

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

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 31

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 31

NPI Registry JSON

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

{
    "created_epoch": "1301529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1013206002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 FLUME ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7979 W RIFLEMAN ST STE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049066",
            "telephone_number": "208-340-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAWTOOTH PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-31",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-340-5099",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT MS OCS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "ID",
            "license": "PT 1938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.