Individual provider Active NPI

Tyson Jade Fox, DPT

  • Physical Therapist
  • Boise, ID
National Provider Identifier
1902627409
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8971055 Issued in ID
Practice address
7711 W Riverside Dr
Boise, ID 83714-6254
Phone
(208) 813-9544
Fax
(208) 810-4499
NPI assigned
Oct 18, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8971055 ID Primary

Addresses

Primary practice location

7711 W Riverside Dr
Boise, ID 83714-6254

Mailing address

7711 W Riverside Dr
Boise, ID 83714-6254
Phone (208) 813-9544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250605000661 ID Practitioner - Physical Therapist in Private Practice 5092224584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7711 W Riverside Dr
Boise, ID 83714-6182
Phone (208) 813-9544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8971055IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wright Physical Therapy Limited Partnership Physical Therapist CurrentSince May 23, 2025 Accepting new patients
Wright Physical Therapy Limited Partnership Physical Therapist CurrentSince May 23, 2025 Accepting new patients

Locations

7711 W Riverside Dr
Boise, ID 83714
Phone (208) 813-9544

1444 Falls Ave E
Twin Falls, ID 83301
Phone (208) 736-2574

1411 Falls Ave E
Ste 401
Twin Falls, ID 83301
Phone (208) 969-9945

Organizations & group practices 2

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": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1902627409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7711 W RIVERSIDE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837146254",
            "telephone_number": "208-813-9544",
            "fax_number": "208-810-4499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7711 W RIVERSIDE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837146254",
            "telephone_number": "208-813-9544",
            "fax_number": "208-810-4499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "TYSON",
        "middle_name": "JADE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-18",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "8971055",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 23, 2025; 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.