Active NPI
Kirsten Evensen, OTR L
- Occupational Therapist
- Boise, ID
National Provider Identifier
1720111826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-500
- Practice address
- 890 N Cole Rd
Ste a
Boise, ID 83704-8638 - Phone
- (208) 323-8888
- Fax
- (208) 323-8889
- NPI assigned
- Mar 14, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT-500 | ID | Primary |
Addresses
Primary practice location
890 N Cole Rd
Ste a
Boise, ID 83704-8638
Mailing address
PO Box 1730
McCall, ID 83638-1730
Phone (208) 634-9788
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT-500 | ID | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Therapy Place, Inc. | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Professional Therapy Services, Inc.
- Occupational Therapist
- Boise, ID
- NPI 1649281577
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720111826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1730",
"city": "MCCALL",
"state": "ID",
"postal_code": "836381730",
"telephone_number": "208-634-9788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "890 N COLE RD",
"address_2": "STE A",
"city": "BOISE",
"state": "ID",
"postal_code": "837048638",
"telephone_number": "208-323-8888",
"fax_number": "208-323-8889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVENSEN",
"first_name": "KIRSTEN",
"credential": "OTR L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ID",
"license": "OT-500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.