NPIMap

Organization Active NPI

Ada Therapy Services PLLC

  • Occupational Therapist
  • Boise, ID
National Provider Identifier
1285133017
Registry record updated Feb 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-1345 Issued in ID
Legal business name
ADA THERAPY SERVICES PLLC
Practice address
4696 W Overland Rd Ste 232
Boise, ID 83705-2864
Phone
(208) 908-6116
Fax
(208) 908-0486
NPI assigned
Feb 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2018

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

Authorized official

Name
Amanda Craig, OTNPI 1710393004
Title
Provider, Owner
Phone
(208) 908-6116

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X OT-1345 ID Primary

Addresses

Primary practice location

4696 W Overland Rd Ste 232
Boise, ID 83705-2864

Mailing address

4696 W Overland Rd Ste 232
Boise, ID 83705-2864
Phone (208) 908-6116

Other identifiers 1

IdentifierTypeStateIssuer
OT-1345OtherIDSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180605002117 ID Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9931464351 Receives reassigned benefits from 4 practitioners
Practice locations: Boise, ID

National Provider Directory

National Provider Directory

Locations

5400 W Franklin Rd
Ste H
Boise, ID 83705
Phone (208) 345-1170

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517961600000",
    "number": "1285133017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4696 W OVERLAND RD STE 232",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052864",
            "telephone_number": "208-908-6116",
            "fax_number": "208-908-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4696 W OVERLAND RD STE 232",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837052864",
            "telephone_number": "208-908-6116",
            "fax_number": "208-908-0486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADA THERAPY SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-07",
        "last_updated": "2018-02-07",
        "status": "A",
        "authorized_official_last_name": "CRAIG",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "PROVIDER, OWNER",
        "authorized_official_telephone_number": "208-908-6116",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-1345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "OT-1345",
            "state": "ID"
        }
    ],
    "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 Feb 7, 2018; 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.

Verify at the official NPI Registry.