KEYSTONE THERAPY (NPI# 1063951168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063951168 |
| Entity Type | Organization |
| Organization Name | KEYSTONE THERAPY |
| Practice Address |
1159 E Iron Eagle Dr Suite 170d Eagle ID 83616-6871 |
| Practice Telephone | 2085140670 |
| Practice Fax Number | 2085497880 |
| Mailing Telephone | 2085140670 |
| Mailing Fax Number | 2085497880 |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2017-02-22 |
| Authorized Official Name | LEONARD JENSEN (PRESIDENT) |
| Authorized Official Telephone | 2085140670 |
| Authorized Official Credential | FNP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | Keystone Therapy and Consulting PLLC | 10130 Mallard Creek Road, Suite 300, Charlotte, NC 28262 |
| Virginia Business Entities | Keystone Therapy Group LLC | 10560 Main St Ste 511, Fairfax, Virginia 22030-7173 |
| Washington State Corporations | KEYSTONE THERAPY, PLLC | 619 N 35th St, #202, Seattle, WA 98103-8640 |
| Street Address |
1159 E IRON EAGLE DR SUITE 170D |
| City | EAGLE |
| State | ID |
| Zip Code | 83616-6871 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033395876 | Jill Mitchell | Marriage & Family Therapist | 1159 E Iron Eagle Dr, Suite 170-f, Eagle, ID 83616-6871 | 2008-01-10 |
| 1952852642 | Kami Crnich Bellomy | Nurse Practitioner | 1159 E Iron Eagle Dr, Suite 170d, Eagle, ID 83616-6871 | 2016-10-18 |
| 1881084721 | Keystone Home Health, LLC | Home Health | 1159 E Iron Eagle Dr, Suite 170-d, Eagle, ID 83616-6871 | 2015-01-30 |
| 1851604904 | Leonard Jensen | Nurse Practitioner | 1159 E Iron Eagle Dr, Eagle, ID 83616-6871 | 2010-07-19 |
| 1922276492 | Lifestyles Chiropractic | Chiropractor | 1159 E Iron Eagle Dr, Ste. 100, Eagle, ID 83616-6871 | 2008-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714049 | Care Medical Housecalls PC | Nurse Practitioner | 2040 E Holgate Ct, Eagle, ID 83616 | 2020-03-06 |
| 1629613823 | Counseling Solutions Center LLC | Marriage & Family Therapist | 2618 East Snocreek, Eagle, ID 83616 | 2019-11-12 |
| 1245726918 | Tracy Lyn Hagadorn | Midwife | 182 State Street, Eagle, ID 83616 | 2018-07-06 |
| 1861922627 | Nicholas A. Stelzner | Counselor | 2419 W. State St. Suite 8, Boise, ID 83616 | 2017-06-14 |
| 1184080210 | Gabriel Guerrero | Dermatology | 323 E Riverside Dr Ste 234, Eagle, ID 83616 | 2016-01-05 |
| 1376940668 | Cecilia Jo Hickam | Dental Hygienist | 1121 E. State Street, Suite - 102-d, Eagle, ID 83616 | 2014-12-02 |
| 1871912634 | Christine E Birch | Psychiatry & Neurology | 1032 S Bridgeway Pl Ste 110, Eagle, ID 83616 | 2014-04-09 |
| 1043552524 | Tori Croshaw | Social Worker | 372 S Eagle Rd Ste 190, Eagle, ID 83616 | 2013-03-21 |
| 1053650010 | Kellie Ann Northam | Nurse Practitioner | 192 West State Street, Eagle, ID 83616 | 2013-02-11 |
| 1437494457 | Mary Beth Roehling | Nurse Practitioner | 2040 E Hologate Ct, Eagle, ID 83616 | 2012-12-03 |
| Find all providers in zip 83616 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700307618 | Altius Rehabilitation and Wellness, Pllc | Clinic/Center | 850 Chambers Ave, Eagle, CO 81631-0101 | 2017-06-30 |
| 1740537646 | Competitive Edge Physical Therapy and Fitness | Clinic/Center | 247 Ring Neck, Eagle, CO 81631 | 2012-08-09 |
| 1962720532 | Milestones, LLC | Clinic/Center | 327 Howard Street, Eagle, CO 81631 | 2010-05-06 |
| 1528150091 | Tk Howell Enterprises Inc | Clinic/Center | 539 S Fitness Pl, Suite 100, Eagle, ID 83616-6552 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376150581 | Meridian Mama's Physical Therapy | Clinic/Center | 309 W Emma Ave, Coeur D Alene, ID 83814-2522 | 2020-09-30 |
| 1033726880 | Moscow Physical Therapy, LLC | Clinic/Center | 1174 Alturas Drive, Suite 2, Moscow, ID 83843 | 2020-09-25 |
| 1356964449 | Vibrant Physical Therapy & Wellness | Clinic/Center | 1111 S Orchard St Ste 104, Boise, ID 83705-1961 | 2020-05-22 |
| 1477193795 | Zona Physical Therapy | Clinic/Center | 11483 W Fairview Ave, Boise, ID 83713-7940 | 2020-01-15 |
| 1225676372 | Mike Dusbabek Physical Therapy, Pllc | Clinic/Center | 609 S Dollar St, Coeur D Alene, ID 83814-3828 | 2019-12-19 |
| 1922665934 | Dahle Physical Therapy, Pllc | Clinic/Center | 812 Shoup St., Salmon, ID 83467-4305 | 2019-05-24 |
| 1598222713 | Salmon Speech and Swallowing Service | Clinic/Center | 700 Riverfront Dr Rm 1, Salmon, ID 83467-5190 | 2019-02-24 |
| 1134625338 | Idaho Falls Hand Therapy Limited Partnership | Clinic/Center | 564 S Woodruff Avenue, Idaho Falls, ID 83401 | 2018-04-05 |
| 1427565845 | Premier Physical Therapy Inc | Clinic/Center | 13967 W Wainwright Dr Ste 104, Boise, ID 83713-2094 | 2018-01-08 |
| 1790294973 | The Pt Next Door | Clinic/Center | 6098 E. Grand Prairie Drive, Boise, ID 83716 | 2017-09-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.