Active NPI
Charles Sands, PT
- Physical Therapist
- Boise, ID
National Provider Identifier
1821034513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT538
- Practice address
- 7550 W Emerald St
Boise, ID 83704-9015 - Phone
- (208) 375-0666
- Fax
- (208) 375-2996
- NPI assigned
- Jun 21, 2006
- Last updated
- Jul 9, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT538 | ID | Primary |
Addresses
Primary practice location
7550 W Emerald St
Boise, ID 83704-9015
Mailing address
7550 W Emerald St
Boise, ID 83704-9015
Phone (208) 375-0666
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010006921 | Other | ID | BLUE SHIELD OF IDAHO |
| T8067 | Other | ID | BLUE CROSS OF IDAHO |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1821034513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7550 W EMERALD ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837049015",
"telephone_number": "208-375-0666",
"fax_number": "208-375-2996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7550 W EMERALD ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837049015",
"telephone_number": "208-375-0666",
"fax_number": "208-375-2996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDS",
"first_name": "CHARLES",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT538",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD OF IDAHO",
"identifier": "000010006921",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF IDAHO",
"identifier": "T8067",
"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 9, 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.