Boise River Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070011785 Issued in IL

Legal business name

BOISE RIVER PHYSICAL THERAPY

Doing business as

Boise River Physical Therapy

Practice address

64 S Star Road
Suite 2
Star, ID 83669

Phone

(815) 540-6065

Fax

(815) 380-6355

NPI assigned

Jun 1, 2015

Organization subpart

No

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

Authorized official

Name

Jon Link, PT, MPT, OCS, CSCS

Title

Owner

Phone

(815) 540-6065

Specialties & licenses 1

Addresses

Other names 1

• Boise River Physical Therapy Doing business as

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436832000000",
    "number": "1285014779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 S STAR ROAD",
            "address_2": "SUITE 2",
            "city": "STAR",
            "state": "ID",
            "postal_code": "83669",
            "telephone_number": "815-540-6065",
            "fax_number": "815-380-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 S STAR ROAD",
            "address_2": "SUITE 2",
            "city": "STAR",
            "state": "ID",
            "postal_code": "83669",
            "telephone_number": "815-540-6065",
            "fax_number": "815-380-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOISE RIVER PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-07-14",
        "status": "A",
        "authorized_official_last_name": "LINK",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-540-6065",
        "authorized_official_credential": "PT, MPT, OCS, CSCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070011785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boise River Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Beverlee K Furner, NP PLLC (Star Medical Center)
• Douglas Birkland
• Rachel Raelene Bobst, MS, LPC
• Sarah Bodily, OTR/L
• Jeremy J Boethin, D.C.
• Matthew Bolen
• Kari Lynne Bouffard-Cheng
• Katherine Gail Buracchio, APRN, PMHNP-BC
• Debra Dee Cammann
• Paige Elizabeth Casey, M.S

• Physical Therapist in Star, ID
• Providers in Star, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; 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.