Active NPI
Jordan Pollock
- Occupational Therapist
- Boise, ID
National Provider Identifier
1730649641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-1855
- Practice address
- 7960 W Rifleman St Ste 130
Boise, ID 83704-9014 - Phone
- (208) 377-1310
- NPI assigned
- Mar 25, 2019
- Sex
- Male
- Sole proprietor
- Yes
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-1855 | ID | Primary |
Addresses
Primary practice location
7960 W Rifleman St Ste 130
Boise, ID 83704-9014
Mailing address
7960 W Rifleman St Ste 130
Boise, ID 83704-9014
Phone (208) 377-1310
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-1855 | ID | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rainbow Children'S Therapy | Current | 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 and National Provider Directory roles.
-
- Rehabilitation Clinic/Center
- Caldwell, ID
- NPI 1013585819
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553472000000",
"number": "1730649641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7960 W RIFLEMAN ST STE 130",
"city": "BOISE",
"state": "ID",
"postal_code": "837049014",
"telephone_number": "208-377-1310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7960 W RIFLEMAN ST STE 130",
"city": "BOISE",
"state": "ID",
"postal_code": "837049014",
"telephone_number": "208-377-1310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLLOCK",
"first_name": "JORDAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-25",
"last_updated": "2019-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "ID",
"license": "OT-1855",
"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 Mar 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.