Boise Outdoor OT

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

Legal business name

BOISE OUTDOOR OT

Practice address

522 E 40TH St
Garden City, ID 83714-6358

Phone

(323) 640-2305

NPI assigned

Aug 19, 2021

Organization subpart

No

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

Authorized official

Name

Daniele Fallon, MANPI 1235511510

Title

Occupational Therapist

Phone

(208) 918-2657

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniele Fallon, OTR

  • Pediatric Occupational Therapist
  • Garden City, ID
  • NPI 1235511510

  Pediatrics

  NPD Authorized official

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787270400000",
    "number": "1619643590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 E 40TH ST",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837146358",
            "telephone_number": "208-916-2657",
            "fax_number": "208-906-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 E 40TH ST",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837146358",
            "telephone_number": "323-640-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOISE OUTDOOR OT",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-19",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A",
        "authorized_official_last_name": "FALLON",
        "authorized_official_first_name": "DANIELE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "208-918-2657",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew M Bender, MD
• Bennett Medical Services
• Bloom Idaho LLC
• Marcee Michelle Boggs, ED.D.
• Boise Experiential Therapy Collective
• Janett Bowen, REGISTERED NURSE
• Linda Kathelene Bowen, LCSW
• Breakaway, Inc
• Carrie Boroughs Breaux, DVM DACVO
• Fernando Juan Busby, PA

• Pediatric Occupational Therapist in Garden City, ID
• Providers in Garden City, ID by specialty
• Pediatric Occupational Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.