NPIMap

Organization Active NPI

CSRM LLC

Doing business as Kestrel Therapy Group

  • Hand Occupational Therapist
  • Nampa, ID
National Provider Identifier
1306583109
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
Legal business name
CSRM LLC
Doing business as
Kestrel Therapy Group
Practice address
16816 N Marketplace Blvd
Nampa, ID 83687-5140
Phone
(208) 461-9593
Fax
(208) 369-9272
NPI assigned
May 13, 2022
Last updated
Sep 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Authorized official

Name
Ronald Dale MillerNPI 1952352601
Title
Owner
Phone
(208) 377-3850

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
Hand Occupational Therapist 225XH1200X NU Primary

Addresses

Primary practice location

16816 N Marketplace Blvd
Nampa, ID 83687-5140

Mailing address

7979 W Rifleman St Ste 200
Boise, ID 83704-9066
Phone (208) 377-3850

Other names 1

  • Kestrel Therapy Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230126001625 ID DME Supplier - Independently-Practicing Occupational Therapist 4789078312 Practice locations: Nampa, ID

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • CSRM LLC

    dba Kestrel Therapy Group

    • Hand Occupational Therapist
    • Boise, ID
    • NPI 1083337711

    4789078312

    Same PAC ID
  • CSRM LLC

    dba Kestrel Therapy Group

    • Hand Occupational Therapist
    • Meridian, ID
    • NPI 1588301386

    4789078312

    Same PAC ID
  • CSRM LLC

    dba Kestrel Therapy Group

    • Physical Therapist
    • Boise, ID
    • NPI 1669132353

    4789078312

    Same PAC ID

National Provider Directory

National Provider Directory
Tax ID family
CSRM LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

  • CSRM LLC

    dba Kestrel Therapy Group

    • Hand Occupational Therapist
    • Boise, ID
    • NPI 1083337711
    NPD tax ID
  • CSRM LLC

    dba Kestrel Therapy Group

    • Hand Occupational Therapist
    • Meridian, ID
    • NPI 1588301386
    NPD tax ID
  • CSRM LLC

    dba Kestrel Therapy Group

    • Physical Therapist
    • Boise, ID
    • NPI 1669132353
    NPD tax ID

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1652400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1306583109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7979 W RIFLEMAN ST STE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049066",
            "telephone_number": "208-377-3850",
            "fax_number": "208-369-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16816 N MARKETPLACE BLVD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875140",
            "telephone_number": "208-461-9593",
            "fax_number": "208-369-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSRM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-13",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-377-3850"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kestrel Therapy Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kestrel Therapy Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.