Individual provider Active NPI

Terri Dale Whitmore, P.T.A.

  • Physical Therapy Assistant
  • Boise, ID
National Provider Identifier
1285840058
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA-360 Issued in ID
Practice address
1130 Allumbaugh St
Boise, ID 83704-8700
Phone
(208) 854-8502
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA-360 ID Primary

Addresses

Primary practice location

1130 Allumbaugh St
Boise, ID 83704-8700

Mailing address

2964 W Mirmonte St
Meridian, ID 83642-2680
Phone (208) 895-0187

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
PTA-360IDMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285840058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2964 W MIRMONTE ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422680",
            "telephone_number": "208-895-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 ALLUMBAUGH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048700",
            "telephone_number": "208-854-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITMORE",
        "first_name": "TERRI",
        "middle_name": "DALE",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ID",
            "license": "PTA-360",
            "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 Jul 8, 2007; 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.