Individual provider Active NPI

Dustin W Cosby, DPT

  • Physical Therapist
  • Nampa, ID
National Provider Identifier
1619216710
Registry record updated Feb 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-3147 Issued in ID
Practice address
337 W Iowa Ave
Nampa, ID 83686-2856
Phone
(208) 467-7889
Fax
(208) 467-7800
NPI assigned
Feb 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2013

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-3147 ID Primary

Addresses

Primary practice location

337 W Iowa Ave
Nampa, ID 83686-2856

Mailing address

2176 E Franklin Rd
Suite 100
Meridian, ID 83642-9024
Phone (208) 288-1155

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130320000544 ID Practitioner - Physical Therapist in Private Practice 6103061221 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-3147IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabauthority, LLC Physical Therapist PastSince Jan 3, 2011 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1360281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360281600000",
    "number": "1619216710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2176 E FRANKLIN RD",
            "address_2": "SUITE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429024",
            "telephone_number": "208-288-1155",
            "fax_number": "208-288-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 W IOWA AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862856",
            "telephone_number": "208-467-7889",
            "fax_number": "208-467-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSBY",
        "first_name": "DUSTIN",
        "middle_name": "W",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-08",
        "last_updated": "2013-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-3147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2013; 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.