Active NPI
Samuel Taylor Mulford, PT, DPT
- Physical Therapist
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7621
- Practice address
- 554 N Steelhead Way Ste 162
Boise, ID 83704-8388 - Phone
- (208) 323-9747
- Fax
- (208) 323-9752
- NPI assigned
- Jun 3, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4271 | NV | |
| Physical Therapist | 225100000X | 7621 | ID | Primary |
Addresses
Primary practice location
554 N Steelhead Way Ste 162
Boise, ID 83704-8388
Mailing address
1411 Falls Ave E Ste 401
Twin Falls, ID 83301-3455
Phone (082) 969-9945
Other practice location 1
9070 W.Cheyenne Ave
Suite 100
henderson, NV 89074
Phone (702) 818-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1444 Falls Ave E
Twin Falls, ID 83301-3408
Phone (208) 736-2574
931 Ctr St W
Suite C
Kimberly, ID 83341-5326
Phone (208) 423-9999
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7621 | ID | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wright Physical Therapy Limited Partnership | Physical Therapist | Current | Accepting new patients |
| Wright Physical Therapy Limited Partnership | Physical Therapist | Current | Accepting new patients |
Locations
554 N Steelhead Way
Ste 162
Boise, ID 83704
Phone (208) 323-9747
931 Center St W
#C
Kimberly, ID 83341
Phone (208) 423-9999
1444 Falls Ave E
Twin Falls, ID 83301
Phone (208) 736-2574
1411 Falls Ave E
Ste 401
Twin Falls, ID 83301
Phone (208) 969-9945
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.
-
- Physical Therapist
- Twin Falls, ID
- NPI 1730732025
-
- Physical Therapist
- Logan, UT
- NPI 1770317455
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630281600000",
"number": "1194349381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1411 FALLS AVE E STE 401",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833013455",
"telephone_number": "082-969-9945",
"fax_number": "208-944-0488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "554 N STEELHEAD WAY STE 162",
"city": "BOISE",
"state": "ID",
"postal_code": "837048388",
"telephone_number": "208-323-9747",
"fax_number": "208-323-9752"
}
],
"practiceLocations": [
{
"address_1": "9070 W.Cheyenne Ave",
"address_2": "Suite 100",
"address_purpose": "LOCATION",
"city": "henderson",
"state": "NV",
"postal_code": "89074",
"country_code": "US",
"telephone_number": "702-818-5000",
"fax_number": "702-818-5001",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MULFORD",
"first_name": "SAMUEL",
"middle_name": "TAYLOR",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-06-03",
"last_updated": "2021-08-30",
"certification_date": "2021-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "4271",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "7621",
"primary": true
}
],
"identifiers": [],
"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 Aug 30, 2021; 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.