Individual provider Active NPI

Alice Sternke, RPT

  • Physical Therapist
  • Boise, ID
National Provider Identifier
1104879261
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-114 Issued in ID
Practice address
1785 Danmore Dr
Boise, ID 83712-6606
Phone
(208) 343-1173
Fax
(208) 736-0890
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-114 ID Primary

Addresses

Primary practice location

1785 Danmore Dr
Boise, ID 83712-6606

Mailing address

PO Box 1886
Twin Falls, ID 83303-1886
Phone (208) 736-0887

Other identifiers 3

IdentifierTypeStateIssuer
000010018457OtherIDREGENCE
T0643OtherIDBLUE CROSS
804083800MedicaidID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060905000393 ID Practitioner - Physical Therapist in Private Practice 4587668603 Practice locations: Boise, ID

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-114IDMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1104879261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1886",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833031886",
            "telephone_number": "208-736-0887",
            "fax_number": "208-736-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 DANMORE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126606",
            "telephone_number": "208-343-1173",
            "fax_number": "208-736-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERNKE",
        "first_name": "ALICE",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "000010018457",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "T0643",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804083800",
            "state": "ID"
        }
    ],
    "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 Dec 7, 2023; 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.