Organization Active NPI

Northwest Pediatric Therapy LLC

  • Pediatric Occupational Therapist
  • Hayden, ID
National Provider Identifier
1528846557
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
NORTHWEST PEDIATRIC THERAPY LLC
Practice address
1130 W Hayden Ave #103
Hayden, ID 83835
Phone
(208) 450-2094
Fax
(208) 908-0044
NPI assigned
Sep 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Authorized official

Name
Mrs. Megan McMaster-Stine, CCC-SLPNPI 1740793405
Title
Co-Owner
Phone
(208) 660-4873

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

1130 W Hayden Ave #103
Hayden, ID 83835

Mailing address

1130 W Hayden Ave Ste 103
Hayden, ID 83835-8720
Phone (208) 450-2094

Other identifiers 1

IdentifierTypeStateIssuer
1528846557MedicaidID

National Provider Directory

National Provider Directory

Locations

1130 W Hayden Ave
Ste 103
Hayden, ID 83835
Phone (208) 450-2094

Practitioners & affiliated clinicians

Practitioners 2

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": "1695168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1528846557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 W HAYDEN AVE STE 103",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358720",
            "telephone_number": "208-450-2094",
            "fax_number": "208-908-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 W HAYDEN AVE #103",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "83835",
            "telephone_number": "208-450-2094",
            "fax_number": "208-908-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-20",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "MCMASTER-STINE",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "208-660-4873",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528846557",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayden, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.