Jeremiah Kirtland Yates, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-1973 Issued in ID

Practice address

241 Main St
Gooding, ID 83330-1103

Phone

(208) 934-4433

Fax

(208) 934-4639

NPI assigned

May 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Canyon Medical Center IncGroup PAC ID 0941371439, 73 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Canyon Medical Center Inc.

  • Critical Access Hospital
  • Gooding, ID
  • NPI 1609046671
  Medicare reassignment Care Compare group NPD
• North Canyon Medical Center, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Gooding, ID
  • NPI 1275703241
  NPD
• North Canyon Medical Center, Inc.

  • Radiology Clinic/Center
  • Twin Falls, ID
  • NPI 1700641636
  NPD
• Inland Cardiology Associates, P.S.

  • Cardiovascular Disease Physician
  • Spokane, WA
  • NPI 1679522106
  NPD (past)

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1083815757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 CAYUSE CREEK DRIVE",
            "city": "KIMBERLY",
            "state": "ID",
            "postal_code": "83341",
            "telephone_number": "208-736-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 MAIN ST",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "833301103",
            "telephone_number": "208-934-4433",
            "fax_number": "208-934-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "JEREMIAH",
        "middle_name": "KIRTLAND",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-30",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-1973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Toone, TSLP
• Connie Vankleeck, OTR/L
• Judith Marie Walburn, PTA-245
• Jennifer A Wert, LMSW
• Stephen M Williams, PAC
• Gamile Yow, CADC, BA

• Physical Therapist in Gooding, ID
• Providers in Gooding, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.