Paula K PT LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PAULA K PT LLC

Practice address

5995 W State St Ste a
Garden City, ID 83703-3085

Phone

(208) 283-7291

Fax

(208) 254-5206

NPI assigned

Jun 25, 2024

Last updated

Jun 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paula Augustina Kosberg, DPTNPI 1770878779

Title

Owner/ Physical Therapist

Phone

(208) 283-7291

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Paula Augustina Kosberg

  • Physical Therapist
  • Boise, ID
  • NPI 1770878779
  NPD Authorized official

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1417792235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5995 W STATE ST STE A",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837033085",
            "telephone_number": "208-283-7291",
            "fax_number": "208-254-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5995 W STATE ST STE A",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837033085",
            "telephone_number": "208-283-7291",
            "fax_number": "208-254-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAULA K PT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "KOSBERG",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "AUGUSTINA",
        "authorized_official_title_or_position": "OWNER/ PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "208-283-7291",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Garden City, ID
• Providers in Garden City, ID by specialty
• Physical Therapy Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.