Eric Taeho Yoon, PT, DPT, CSCS

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

PT-8815 Issued in ID

Practice address

1109 W Myrtle St
Boise, ID 83702-6970

Phone

(208) 385-3720

NPI assigned

Jul 12, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1275212805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 N 10TH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837023628",
            "telephone_number": "678-613-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 W MYRTLE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026970",
            "telephone_number": "208-385-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "ERIC",
        "middle_name": "TAEHO",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "ID",
            "license": "PT-8815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda K Yoder, RPT
• Sarah L. Yoder, B.S.,COTA
• Yoeli Park, PLLC
• Nicholas J Yokan, M.D.
• Marc Alan Yonkers, M.D./PH.D.
• Kyle R. Yorgason, D.P.M.
• Ruth Cortner York, MPH, CPC
• Phyllis Jenn You, MD
• Dean Younce, DMD
• Amber Morse Young, M.ED. BCBA

• Sports Physical Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Sports Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.