Individual provider Active NPI

Deborah Himebaugh

  • Physical Therapist
  • Coeur d'Alene, ID
National Provider Identifier
1932305976
Registry record updated Oct 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1865 Issued in ID
Practice address
210 W Lacrosse Ave
Coeur D Alene, ID 83814-2403
Phone
(208) 664-2185
NPI assigned
Jun 26, 2007
Last updated
Oct 17, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT1865 ID Primary
Physical Therapist 225100000X PT0005055 WA

Addresses

Primary practice location

210 W Lacrosse Ave
Coeur D Alene, ID 83814-2403

Mailing address

24121 E Broadway CT
Liberty Lake, WA 99019-9671

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

LicenseStateTypeSpecialty
PT1865IDMDPhysical Therapist
PT0005055WAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224201600000",
    "number": "1932305976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24121 E BROADWAY CT",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990199671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W LACROSSE AVE",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142403",
            "telephone_number": "208-664-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMEBAUGH",
        "first_name": "DEBORAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2008-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT1865",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT0005055",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2008; 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.