Mark Richard Shaltry, OTR CHT

Primary specialty

Hand Occupational TherapistTaxonomy code 225XH1200X

License

OT042 Issued in ID

Practice address

554 N Steelhead Way
Ste 162
Boise, ID 83704

Phone

(208) 323-9747

Fax

(208) 323-9752

NPI assigned

Feb 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Advanced Family Medicine PLLC

  • Family Medicine Physician
  • Kuna, ID
  • NPI 1598822231
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1568437697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 E STONEWATER CT",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "83706",
            "telephone_number": "208-323-9747",
            "fax_number": "208-323-9752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 N STEELHEAD WAY",
            "address_2": "STE 162",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-323-9747",
            "fax_number": "208-323-9752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALTRY",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "OTR CHT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT042",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "ID",
            "license": "OT042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rakesh R Shah, MD
• Susan Kelli Shake
• Terry Shake
• Elizabeth Ada Shakespeare, LMT
• Emily Elizabeth Shaleen, BCBA
• Shelby Shanaberger, RD
• Alexis E Shanahan, MD
• Shanell Larae LLC
• Dori A Shaner, LPC
• Kimberli Shaner, MS CCC-SLP

• Hand Occupational Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Hand Occupational Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.