Individual provider Active NPI

Taylor A Cavazos, PT

  • Physical Therapist
  • Boise, ID
National Provider Identifier
1952967671
Registry record updated May 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-6090 Issued in ID
Practice address
3040 N Five Mile Rd
Boise, ID 83713-5234
Phone
(208) 939-0533
Fax
(208) 939-3341
NPI assigned
May 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2019

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 PT-6090 ID Primary

Addresses

Primary practice location

3040 N Five Mile Rd
Boise, ID 83713-5234

Mailing address

12072 W McMillan Rd
Boise, ID 83713-2462
Phone (208) 939-0533

Other practice location 1

2316 S Eagle Rd
Meridian, ID 83642-2665
Phone (208) 939-0533

Other practice location 2

12072 W McMillan Rd
Boise, ID 83713-2462
Phone (208) 939-0533

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-6090IDMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558051200000",
    "number": "1952967671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12072 W MCMILLAN RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837132462",
            "telephone_number": "208-939-0533",
            "fax_number": "208-939-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 N FIVE MILE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135234",
            "telephone_number": "208-939-0533",
            "fax_number": "208-939-3341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2316 S Eagle Rd",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836422665",
            "country_code": "US",
            "telephone_number": "208-939-0533",
            "fax_number": "208-939-3341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12072 W McMillan Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837132462",
            "country_code": "US",
            "telephone_number": "208-939-0533",
            "fax_number": "208-939-3341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAVAZOS",
        "first_name": "TAYLOR",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-17",
        "last_updated": "2019-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-6090",
            "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 17, 2019; 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.