Active NPI
Northwest Pediatric Therapy LLC
- Pediatric Occupational Therapist
- Hayden, ID
National Provider Identifier
1528846557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Megan McMaster-Stine, CCC-SLP
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | Primary | ||
| Speech-Language Pathologist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528846557 | Medicaid | ID |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Speech-Language Pathologist
- Hayden, ID
- NPI 1740793405
-
- Occupational Therapist
- Coeur D Alene, ID
- NPI 1467710954
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
- Northwest Counseling Services PLLC
- Northwest Counseling Services PLLC
- Northwest Medical Transport LLC
- Northwest Natural Dentistry GPS PLLC
- Northwest Pediatric Speech Therapy, LLC
- Northwoods Chiropractic Inc
- Nuback Institute of North Idaho, LLC
- Jeanie B. Nugent, DC
- Justin Teague Odell, LMT
- Michael L Oglesbay, D.O.
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.