Active NPI
Susan Devine, OT/L
- Orthoptist
- Boise, ID
National Provider Identifier
1376973826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthoptist
- License
- OT-259
- Practice address
- 7960 W Rifleman St
#155
Boise, ID 83704-9064 - Phone
- (208) 377-8899
- Fax
- (208) 321-1952
- NPI assigned
- Nov 20, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthoptist | 156FX1900X | OT-259 | ID | Primary |
Addresses
Primary practice location
7960 W Rifleman St
#155
Boise, ID 83704-9064
Mailing address
7960 W Rifleman St
#155
Boise, ID 83704-9064
Phone (208) 377-8899
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT-259 | ID | MD | Orthoptist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384905600000",
"number": "1376973826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7960 W RIFLEMAN ST",
"address_2": "#155",
"city": "BOISE",
"state": "ID",
"postal_code": "837049064",
"telephone_number": "208-377-8899",
"fax_number": "208-321-1952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7960 W RIFLEMAN ST",
"address_2": "#155",
"city": "BOISE",
"state": "ID",
"postal_code": "837049064",
"telephone_number": "208-377-8899",
"fax_number": "208-321-1952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVINE",
"first_name": "SUSAN",
"credential": "OT/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-20",
"last_updated": "2013-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1900X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Orthoptist",
"state": "ID",
"license": "OT-259",
"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 Nov 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.