Mikaela Virgin, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8477 Issued in ID

Practice address

672 E Wythe Creek CT
Kuna, ID 83634-5216

Phone

(208) 922-9828

NPI assigned

Oct 24, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altitude Physical Therapy IncGroup PAC ID 0244267029, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Altitude Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Caldwell, ID
  • NPI 1619045309
  Medicare reassignment Care Compare group NPD
• Mountain Land Rehabilitation LLC

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1265549372
  NPD (past)
• Registered Physical Therapists LLC

  • Physical Therapy Clinic/Center
  • Sandy, UT
  • NPI 1477582633
  NPD (past)

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1871210500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1185 E TROPHY ST",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836343541",
            "telephone_number": "503-577-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 E WYTHE CREEK CT",
            "city": "KUNA",
            "state": "ID",
            "postal_code": "836345216",
            "telephone_number": "208-922-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRGIN",
        "first_name": "MIKAELA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "8477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Urban, LPC
• Valor Classical Academy of Idaho, LLC
• Alexis Vanacker
• Vic'S Family Pharmacy Inc
• Robert Gray Vining III, MPT
• Virginia Spackman LLC
• Walgreen Co (Walgreens #13614)
• Jeremy Walker, DMD
• Kirsten Wallin
• Edward Walthall, PHARMD

• Physical Therapist in Kuna, ID
• Providers in Kuna, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.