Active NPI
Alice Sternke, RPT
- Physical Therapist
- Boise, ID
National Provider Identifier
1104879261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-114
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010018457 | Other | ID | REGENCE |
| T0643 | Other | ID | BLUE CROSS |
| 804083800 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PT-114 | ID | MD | Physical 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.