Seth Koyle

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

AT-726 Issued in ID

Practice address

1501 Hiland Ave
Burley, ID 83318-2688

Phone

(208) 678-4444

NPI assigned

Jul 3, 2024

Sex

Male

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": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1912743501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 DIAMOND DR",
            "city": "RUPERT",
            "state": "ID",
            "postal_code": "833502219",
            "telephone_number": "208-312-7939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HILAND AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182688",
            "telephone_number": "208-678-4444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "292 W 100 S",
            "address_purpose": "LOCATION",
            "city": "Rupert",
            "state": "ID",
            "postal_code": "833509684",
            "country_code": "US",
            "telephone_number": "208-436-4721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOYLE",
        "first_name": "SETH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "ID",
            "license": "AT-726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael P Klett, D.O.
• Kaity Kobayashi, PT, DPT, PCS
• Heidi Lee Koepnick, LPC
• Susan L Koepnick, LPC
• Karrie Rae Kondel, ARNP
• Mary Kraemer
• Evan Kress, PT
• Brett Jack Lancaster, D.M.D
• Michael Andrew Larsen, D.D.S.
• Melissa Jo Larson, LPC

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Burley, ID
• Providers in Burley, ID by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.