Active NPI
Kimberly Kathaleen Trulli, RMT
- Massage Therapist
- Boise, ID
National Provider Identifier
1063662591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 49748
- Practice address
- 1786 W. State Street
Boise, ID 83702 - Phone
- (208) 331-1786
- NPI assigned
- Sep 20, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 49748 | CA | Primary |
Addresses
Primary practice location
1786 W. State Street
Boise, ID 83702
Mailing address
1786 W. State Street
Boise, ID 83702
Phone (208) 869-1388
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1049017 | Other | CA | ASHP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49748 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681257600000",
"number": "1063662591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1786 W. STATE STREET",
"city": "BOISE",
"state": "ID",
"postal_code": "83702",
"telephone_number": "208-869-1388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1786 W. STATE STREET",
"city": "BOISE",
"state": "ID",
"postal_code": "83702",
"telephone_number": "208-331-1786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRULLI",
"first_name": "KIMBERLY",
"middle_name": "KATHALEEN",
"name_prefix": "Mrs.",
"credential": "RMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-20",
"last_updated": "2023-04-12",
"certification_date": "2023-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "49748",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHP",
"identifier": "1049017",
"state": "CA"
}
],
"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 Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.