NPIMap

Individual provider Active NPI

Devin Kade Satterthwaite, D.P.T.

  • Physical Therapist
  • Boise, ID
National Provider Identifier
1255676003
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-3049 Issued in ID
Practice address
909 Reserve St.
Boise, ID 83712
Phone
(208) 343-7717
Fax
(208) 336-4629
NPI assigned
Dec 5, 2012
Last updated
Dec 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-3049 ID Primary
Physical Therapist 225100000X 3049 ID

Addresses

Primary practice location

909 Reserve St.
Boise, ID 83712

Mailing address

4560 SE International Way
Ste. 100
Milwaukie, OR 97222
Phone (971) 206-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3049IDMDPhysical Therapist
PT-3049IDMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1255676003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY",
            "address_2": "STE. 100",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "97222",
            "telephone_number": "971-206-5200",
            "fax_number": "971-206-5203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 RESERVE ST.",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83712",
            "telephone_number": "208-343-7717",
            "fax_number": "208-336-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATTERTHWAITE",
        "first_name": "DEVIN",
        "middle_name": "KADE",
        "name_prefix": "Mr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-05",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-3049",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "3049",
            "primary": false
        }
    ],
    "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 Dec 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.