Sydney Jade Poorbaugh, DPT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PT-7109 Issued in ID

Practice address

640 N Eisenhower St
Moscow, ID 83843-9588

Phone

(208) 882-6560

NPI assigned

Jun 8, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1902535552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 BLUE MOUNTAIN CT",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994031693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 N EISENHOWER ST",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838439588",
            "telephone_number": "208-882-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POORBAUGH",
        "first_name": "SYDNEY",
        "middle_name": "JADE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ID",
            "license": "PT-7109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dalton Tanner Pitts
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• Morgan Pook
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• Lesley Anne Portugal, M.D.
• Dave Potter, L.C.P.C.
• Heidi M Poxleitner, PHARMD
• Sara B Presol, FNP-C

• Physical Medicine & Rehabilitation Physician in Moscow, ID
• Providers in Moscow, ID by specialty
• Physical Medicine & Rehabilitation Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.

Verify at the official NPI Registry.