Kenneth Andrew McManus, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MAS-2730 Issued in ID

Practice address

5909 W State St
Boise, ID 83703-3039

Phone

(208) 343-7700

Fax

(208) 331-2591

NPI assigned

Feb 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Mental Health Clinic of Idaho PLLC

  • Psychiatry Physician
  • Boise, ID
  • NPI 1215622048
  NPD (past)
• Peregrine Physical Therapy LLC

  • Physical Therapist
  • Boise, ID
  • NPI 1942128137
  NPD (past)
• Physical Therapy 180 LLC

  • Physical Therapist
  • Boise, ID
  • NPI 1669696910
  NPD (past)

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1659872208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11574 W AZURE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837137879",
            "telephone_number": "435-554-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5909 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837033039",
            "telephone_number": "208-343-7700",
            "fax_number": "208-331-2591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3919 E Overland Rd",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836426710",
            "country_code": "US",
            "telephone_number": "208-898-1468",
            "fax_number": "208-331-2591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMANUS",
        "first_name": "KENNETH",
        "middle_name": "ANDREW",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MAS-2730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Alexander McLellan, PTA
• Brian Lane McMahan, M.D.
• Douglas B McMahon, DO
• Kailee Kole McMahon, LCPC
• Michaela S McMahon
• McMartin LLC
• Michael R McMartin, M.D.
• William Kirk McMartin, DPT
• Michele McMaster
• Julia M McMillen

• Massage Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Massage Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.