Kimberly J Mazzella, P.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-7231 Issued in ID

Practice address

875 S Vanguard Way Ste 110
Meridian, ID 83642-8541

Phone

(208) 960-0932

Fax

(208) 960-0935

NPI assigned

Jul 6, 2006

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

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nichols Therapy Group P.C.Group PAC ID 0345229068, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Nichols Therapy Group PC

  • Physical Therapist
  • Star, ID
  • NPI 1043380769
  Medicare reassignment Care Compare group NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Boise, ID
  • NPI 1487630240
  Medicare reassignment NPD
• Orthopaedic Trauma Consultants of Idaho

  • Orthopaedic Surgery Physician
  • Meridian, ID
  • NPI 1336907450
  NPD
• Therapeutic Associates, Inc.

  • Physical Therapist
  • Meridian, ID
  • NPI 1245572429
  NPD
• Therapeutic Associates Inc

  • Physical Therapist
  • Portland, OR
  • NPI 1144042649
  NPD
• Idaho Gastroenterology Associates, LLP

  • Gastroenterology Physician
  • Boise, ID
  • NPI 1265427256
  NPD (past)
• Mountain Land Rehabilitation LLC

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1265549372
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1730110982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 S VANGUARD WAY STE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428541",
            "telephone_number": "208-960-0930",
            "fax_number": "208-960-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 S VANGUARD WAY STE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428541",
            "telephone_number": "208-960-0932",
            "fax_number": "208-960-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZELLA",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-7231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Luella Jones Maybee, LMT
• Cebu H Maybury, MS, CCC-SLP
• Katerina Mayerle
• Olivia Southard Mayfield, AGPCNP-BC
• Melissa Mazzaglia, SLP-CF
• Tristan Alyssa McAfee, LPC
• Leslie McBride
• Michael McCaleb
• Shemayne Jahner McCarthy, O.D.
• Zach McCarthy

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.