Katrina Shibambo

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

960 S Broadway Ave
Boise, ID 83706-3600

Phone

(208) 433-9211

NPI assigned

Sep 28, 2020

Last updated

Dec 13, 2024By the provider in NPPES

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

Other names 1

• Katrina Tooman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Therapeutic Associates Inc

  dba TAI Boise Physical Therapy State Street

  • Physical Therapist
  • Boise, ID
  • NPI 1326024472
  NPD
• Therapeutic Associates Inc

  dba TAI SE Boise

  • Physical Therapist
  • Boise, ID
  • NPI 1487630240
  NPD
• Therapeutic Associates Inc

  dba TAI - Rock Creek

  • Physical Therapist
  • Portland, OR
  • NPI 1144042649
  NPD
• Therapeutic Associates Inc

  dba TAI - North Creek

  • Physical Therapist
  • Bothell, WA
  • NPI 1114376563
  NPD (past)

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1710594478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD STE 300",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247736",
            "telephone_number": "503-443-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 S BROADWAY AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837063600",
            "telephone_number": "208-433-9211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIBAMBO",
        "first_name": "KATRINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRINA",
            "last_name": "TOOMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Joseph Shevlin, MD
• Sarah K Shewayish, MD
• Douglas J Shey, LPC
• SHH Medical Group Idaho, LLC (Autumn Ridge Medical Group)
• Xiaoming Shi, MD
• Joshua Shieh
• Ali Shields, LCSW
• Michaela Shields, PSYD
• Jeffrey S Shilt, MD
• Keita Shimada, MK, LAT, ATC

• 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 Dec 13, 2024; 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.