Kimberly Ann Boenig, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA-6467 Issued in ID

Practice address

6074 N Discovery Way Ste 110
Boise, ID 83713-0210

Phone

(208) 288-1155

NPI assigned

Mar 5, 2020

Sex

Female

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

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

{
    "created_epoch": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1710512132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6074 N DISCOVERY WAY STE 110",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130210",
            "telephone_number": "208-288-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6074 N DISCOVERY WAY STE 110",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130210",
            "telephone_number": "208-288-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOENIG",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ID",
            "license": "PTA-6467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Body Mechanics LLC
• Body of a Champion Chiropractic, PC
• Body Wise Physical Therapy PLLC
• Kathryn West Boedeker, MS, LPC, NCC
• Jess Seymour Boeder, MS., CCC, SLP
• Mark J Boerner, M.D.
• Brian Max Boesiger, M.D.
• Daniel Richard Boespflug, O.D.
• Taylor K Boettiger, MD
• Josie Boggs, LSWA-IC

• Physical Therapy Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapy Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.