Clifford L Kiracofe PT PA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1579 Issued in ID

Legal business name

CLIFFORD L KIRACOFE PT PA

Practice address

8836 N Hess St
Ste C
Hayden, ID 83835-8718

Phone

(208) 772-6991

Fax

(208) 772-6674

NPI assigned

Jul 25, 2006

Organization subpart

No

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

Authorized official

Name

Clifford Kiracofe

Title

Owner

Phone

(208) 772-6991

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213228800000",
    "number": "1962424952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 293",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838350293",
            "telephone_number": "208-772-6991",
            "fax_number": "208-772-6674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8836 N HESS ST",
            "address_2": "STE C",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358718",
            "telephone_number": "208-772-6991",
            "fax_number": "208-772-6674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFFORD L KIRACOFE PT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2008-06-12",
        "status": "A",
        "authorized_official_last_name": "KIRACOFE",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-772-6991"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT1579",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "1620",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807136100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chiropractic Pain Relief Clinic P a
• Chaysen Chong
• Erica Lea Chvilicek, P.T.
• Erica N Clayton
• James D Clayton
• Coeur Counseling LLC
• Col323 PLLC
• Rebecca Coleman
• Natalie M Colla, RD
• Haley Cooper-Scott, DPT, PT

• Physical Therapist in Hayden, ID
• Providers in Hayden, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.