Active NPI
Jamilyn Marie Fasth, PT, DPT
- Physical Therapist
- Nampa, ID
National Provider Identifier
1851011019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-7221
- Practice address
- 4424 E Flamingo Ave Ste 120
Nampa, ID 83687-9291 - Phone
- (208) 205-0450
- NPI assigned
- Aug 29, 2022
- Last updated
- Aug 29, 2022
- Sex
- Female
- 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 | PT-7221 | ID | Primary |
Addresses
Primary practice location
4424 E Flamingo Ave Ste 120
Nampa, ID 83687-9291
Mailing address
3369 S Holden Ave
Boise, ID 83706-5395
Phone (208) 559-4791
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 |
|---|---|---|---|
| PT-7221 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661731200000",
"number": "1851011019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3369 S HOLDEN AVE",
"city": "BOISE",
"state": "ID",
"postal_code": "837065395",
"telephone_number": "208-559-4791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4424 E FLAMINGO AVE STE 120",
"city": "NAMPA",
"state": "ID",
"postal_code": "836879291",
"telephone_number": "208-205-0450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FASTH",
"first_name": "JAMILYN",
"middle_name": "MARIE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-29",
"last_updated": "2022-08-29",
"certification_date": "2022-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-7221",
"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 Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.