Individual provider Active NPI

Kathryn Margaret Phillips, DPT

  • Physical Therapist
  • Emmett, ID
National Provider Identifier
1639724586
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-6437 Issued in ID
Practice address
809 S Washington Ave
Emmett, ID 83617-3528
Phone
(208) 365-5341
NPI assigned
Aug 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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-6437 ID Primary

Addresses

Primary practice location

809 S Washington Ave
Emmett, ID 83617-3528

Mailing address

7550 W Emerald St
Boise, ID 83704-9015
Phone (208) 375-0765

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191106000988 ID Practitioner - Physical Therapist in Private Practice 4183956444 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Restore Physical Therapy PCGroup PAC ID 0143503607, 9 clinicians

Practice addresses (Care Compare)

5418 N Eagle Rd
Suite 170
Boise, ID 83713-0999
Phone (208) 501-8264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-6437IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Physical Therapy PC Physical Therapist CurrentSince Jun 21, 2021 Accepting new patients
Gem Rehabilitation Services, Inc. Physical Therapist PastSince Aug 11, 2019 Accepting new patients
McCall Physical Therapy, P.a. Physical Therapist PastSince Aug 11, 2019 Accepting new patients

Locations

670 E Riverpark Ln
Ste 400
Boise, ID 83706
Phone (208) 807-2486

5418 N Eagle Rd
Ste 170
Boise, ID 83713
Phone (208) 376-3781

16211 N Brinson St
Spc 100
Nampa, ID 83687
Phone (208) 860-2698

Organizations & group practices 3

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": "1565136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1639724586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7550 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049015",
            "telephone_number": "208-375-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 S WASHINGTON AVE",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836173528",
            "telephone_number": "208-365-5341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "KATHRYN",
        "middle_name": "MARGARET",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-07",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-6437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emmett, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.