Individual provider Active NPI

Jordan Noel Steichen

  • Physical Therapist
  • Boise, ID
National Provider Identifier
1538785050
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-6897 Issued in ID
Practice address
3040 N Five Mile Rd
Boise, ID 83713-5234
Phone
(208) 939-0533
Fax
(208) 939-3341
NPI assigned
Jun 20, 2020
Last updated
Oct 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-6897 ID Primary

Addresses

Primary practice location

3040 N Five Mile Rd
Boise, ID 83713-5234

Mailing address

12072 W McMillan Rd
Boise, ID 83713-2462
Phone (208) 939-0533

Other practice location 1

12072 W McMillan Rd
Boise, ID 83713-2462
Phone (208) 939-0533

Other practice location 2

2316 S Eagle Rd
Meridian, ID 83642-2665
Phone (208) 939-0533

Other practice location 3

1525 S Orchard St
Boise, ID 83705-2620
Phone (208) 939-0533

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200714001985 ID Practitioner - Physical Therapist in Private Practice 9133542822 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-6897IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
ZRJ Inc Physical Therapist CurrentSince Jul 1, 2020 Accepting new patients

Locations

12072 W McMillan Rd
Boise, ID 83713
Phone (208) 939-0533

3040 N Five Mile Rd
Boise, ID 83713
Phone (208) 252-6531

2316 S Eagle Rd
Meridian, ID 83642
Phone (208) 286-2707

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1592611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1538785050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12072 W MCMILLAN RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132462",
            "telephone_number": "208-939-0533",
            "fax_number": "208-939-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 N FIVE MILE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135234",
            "telephone_number": "208-939-0533",
            "fax_number": "208-939-3341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12072 W McMillan Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837132462",
            "country_code": "US",
            "telephone_number": "208-939-0533",
            "fax_number": "208-939-3341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2316 S Eagle Rd",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836422665",
            "country_code": "US",
            "telephone_number": "208-939-0533",
            "fax_number": "208-939-3341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1525 S Orchard St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837052620",
            "country_code": "US",
            "telephone_number": "208-939-0533",
            "fax_number": "208-939-3341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEICHEN",
        "first_name": "JORDAN",
        "middle_name": "NOEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-20",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-6897",
            "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 Oct 26, 2021; 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.