Active NPI
Georgena Yanoff
- Occupational Therapist
- Salmon, ID
National Provider Identifier
1912436395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 945
- Practice address
- 516 Main Street #103
Salmon, ID 83467 - Phone
- (484) 388-9729
- NPI assigned
- Jun 8, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 945 | ID | Primary |
Addresses
Primary practice location
516 Main Street #103
Salmon, ID 83467
Mailing address
516 Main St # 103
Salmon, ID 83467-4219
Phone (484) 388-9729
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 |
|---|---|---|---|
| 945 | ID | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Porgy and Petunia Pediatric Therapy | Current | Accepting new patients |
Locations
516 Main St
Salmon, ID 83467
Phone (484) 388-9729
Organizations & group practices 1
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.
-
- Clinic/Center
- Salmon, ID
- NPI 1568973436
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1912436395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "516 MAIN ST # 103",
"city": "SALMON",
"state": "ID",
"postal_code": "834674219",
"telephone_number": "484-388-9729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 MAIN STREET #103",
"city": "SALMON",
"state": "ID",
"postal_code": "83467",
"telephone_number": "484-388-9729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANOFF",
"first_name": "GEORGENA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-08",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ID",
"license": "945",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salmon, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.