Active NPI
Kristen Magalogo
- Occupational Therapist
- Twin Falls, ID
National Provider Identifier
1114334232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-1337
- Practice address
- 254 River Vista PL
Twin Falls, ID 83301-3006 - Phone
- (208) 734-7333
- Fax
- (208) 734-8350
- NPI assigned
- Jul 21, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT-1337 | ID | Primary |
Addresses
Primary practice location
254 River Vista PL
Twin Falls, ID 83301-3006
Mailing address
254 River Vista PL
Twin Falls, ID 83301-3006
Phone (208) 734-7333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OT-1337 | Other | ID | STATE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT-1337 | ID | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Therapy Source LLC | Occupational Therapist | Current | Accepting new patients |
| Primary Therapy Source, LLC | Occupational Therapist | Current | Accepting new patients |
Locations
254 River Vista Pl
Twin Falls, ID 83301
Phone (208) 734-7333
Organizations & group practices 2
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.
-
- Durable Medical Equipment & Medical Supplies
- Twin Falls, ID
- NPI 1104672682
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405900800000",
"number": "1114334232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "254 RIVER VISTA PL",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833013006",
"telephone_number": "208-734-7333",
"fax_number": "208-734-8350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "254 RIVER VISTA PL",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833013006",
"telephone_number": "208-734-7333",
"fax_number": "208-734-8350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGALOGO",
"first_name": "KRISTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-21",
"last_updated": "2014-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ID",
"license": "OT-1337",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE",
"identifier": "OT-1337",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Twin Falls, ID
- Kabre C Madrigal, DPT
- Erik Madsen, DC
- Kimberly Ann Madsen, CGC
- John Brady Madson, LCSW; ACM-SW; C-SWHC
- Camille C. Magalogo, LCSW, RPT-S
- Eva Azucena Magana, LMSW
- Magic Valley Anesthesiology Associates
- Magic Valley Behavioral Health PLLC
- Magic Valley Dental Anesthesia PLLC
- Magic Valley Denture Center Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.