Janice Louise Waite, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

091PT Issued in ID

Practice address

5521 W State St
Boise, ID 83703-3337

Phone

(208) 853-6220

Fax

(208) 853-0554

NPI assigned

Jul 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Janice Wilbanks Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Myofascial Release Treatment Center of Idaho LLC

  dba Myofascial Release Center of Idaho

  • Physical Therapy Clinic/Center
  • Boise, ID
  • NPI 1295897213
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1972538858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5521 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837033337",
            "telephone_number": "208-853-6220",
            "fax_number": "208-853-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5521 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837033337",
            "telephone_number": "208-853-6220",
            "fax_number": "208-853-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITE",
        "first_name": "JANICE",
        "middle_name": "LOUISE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "091PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANICE",
            "last_name": "WILBANKS",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Travis Wahl
• Jade Anne Wahnschaffe, PHARMD
• Kennedy Kambo Wainaina, PHARM D
• Melissa M. Waine-Cunliffe, OT
• Glenn R. Waite, M.D.
• Katie Diana Waites, PA-C
• Wal-Mart Stores, Inc (Vision Center 30-2861)
• Wal-Mart Stores, Inc (Vision Center 30-2508)
• Laura Elizabeth Walawender, M.D.
• Christina Marie Wald, LMSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; 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.