Individual provider Active NPI

Joan Easton, OTR L

  • Occupational Therapist
  • Boise, ID
National Provider Identifier
1811020902
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-059 Issued in ID
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
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT-059 ID Primary

Addresses

Primary practice location

890 N Cole Rd
Ste a
Boise, ID 83704-8638

Mailing address

769 Palmetto Dr
Eagle, ID 83616-5145
Phone (208) 939-6647

Other identifiers 1

IdentifierTypeStateIssuer
W1085OtherIDBLUE CROSS PROVIDER #

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

LicenseStateTypeSpecialty
OT-059IDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew 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 and National Provider Directory roles.

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": "1811020902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 PALMETTO DR",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165145",
            "telephone_number": "208-939-6647"
        },
        {
            "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": "EASTON",
        "first_name": "JOAN",
        "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-059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "W1085",
            "state": "ID"
        }
    ],
    "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.

Verify at the official NPI Registry.