Kyle Donovan Maughan, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-3478 Issued in ID

Practice address

1001 S Hilton St
Boise, ID 83705-1925

Phone

(509) 552-6910

NPI assigned

Jun 17, 2014

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

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Achieve Physical Therapy PLLCGroup PAC ID 8820177314, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Achieve Physical Therapy PLLC

  • Physical Therapist
  • Boise, ID
  • NPI 1659540995

  ID, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Revolutionary Medicine of Idaho

  • Family Nurse Practitioner
  • Boise, ID
  • NPI 1487493292
  NPD (past)

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1689088726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S HILTON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051925",
            "telephone_number": "509-552-6910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S HILTON ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837051925",
            "telephone_number": "509-552-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUGHAN",
        "first_name": "KYLE",
        "middle_name": "DONOVAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-3478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John C Matunas, DDS
• Larissa Marie Mauer
• Maddi Alizabeth Maughan-Ames
• Delray Maughan, M.D.
• Gunnar Harrison Maughan, MSPO, CPO
• Kalyn C Mauk, CMT
• Spencer O Mauk
• Steven A Mauk, LCP
• Susan Mauk, LCPC
• Sonja Maul, PT, CLT-LANA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; 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.