Individual provider Active NPI

Caitlin Alysse Moreland, DPT

  • Physical Therapist
  • Nampa, ID
National Provider Identifier
1730704602
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7251 Issued in ID
Practice address
1015 12TH Ave S Ste 105
Nampa, ID 83651-4660
Phone
(208) 467-4357
Fax
(208) 467-4395
NPI assigned
Jun 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4303 NV
Physical Therapist 225100000X 7251 ID Primary

Addresses

Primary practice location

1015 12TH Ave S Ste 105
Nampa, ID 83651-4660

Mailing address

90 E Ustick Rd Ste 150
Meridian, ID 83646-6134
Phone (208) 895-0715

Other practice location 1

2225 N McCarran Blvd
Sparks, NV 89431-3365
Phone (775) 359-1199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200810003468 NV Practitioner - Physical Therapist in Private Practice 4688099419 Reassigns benefits to 1 organization
I20220211000202 ID Practitioner - Physical Therapist in Private Practice 4688099419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7251IDMDPhysical Therapist
4303NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Moreland Physical Therapy Prof. Corp. Physical Therapist CurrentSince Jun 10, 2020 Accepting new patients
Intermountain Physical Therapy Limited Partnership Physical Therapist CurrentSince Jul 21, 2024 Accepting new patients
Valley Rehab of Idaho Inc Physical Therapist CurrentSince Jan 1, 2022 Accepting new patients
Intermountain Physical Therapy LP PastSince Feb 7, 2021 Accepting new patients

Locations

582 E Boise Ave
Boise, ID 83706
Phone (916) 209-0235

90 E Ustick Rd
#150
Meridian, ID 83646
Phone (208) 895-0715

1015 12th Ave S
Ste 105
Nampa, ID 83651
Phone (208) 467-4357

2225 N McCarran Blvd
Sparks, NV 89431
Phone (775) 240-7101

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1730704602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 E USTICK RD STE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466134",
            "telephone_number": "208-895-0715",
            "fax_number": "208-895-0746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 12TH AVE S STE 105",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514660",
            "telephone_number": "208-467-4357",
            "fax_number": "208-467-4395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2225 N McCarran Blvd",
            "address_purpose": "LOCATION",
            "city": "Sparks",
            "state": "NV",
            "postal_code": "894313365",
            "country_code": "US",
            "telephone_number": "775-359-1199",
            "fax_number": "775-359-1195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORELAND",
        "first_name": "CAITLIN",
        "middle_name": "ALYSSE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4303",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "7251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.