ZACHARY BRADDOCK (NPI# 1801249545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801249545 |
| Entity Type | Individual |
| Full Name | ZACHARY BRADDOCK |
| Credential | PT, DPT |
| Practice Address |
1109 W Myrtle St Suite 200 Boise ID 83702-6970 |
| Mailing Address |
6578 N Spurwing Way Meridian ID 83646-6454 |
| Practice Telephone | 2084894331 |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | PT-4501 | ID | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1109 W MYRTLE ST SUITE 200 |
| City | BOISE |
| State | ID |
| Zip Code | 83702-6970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477581122 | Kurt J Nilsson | Family Medicine | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2006-06-30 |
| 1194193334 | Candice Chessum | Physical Therapist | 1109 W Myrtle St, Boise, ID 83702-6970 | 2015-09-04 |
| 1083015929 | Julia Hassell | Specialist/Technologist | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2014-09-10 |
| 1982940011 | Lucas Bahnmaier | Specialist/Technologist | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2012-12-18 |
| 1831475284 | Timothy Steven Nicolello | Specialist/Technologist | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2011-10-31 |
| 1992089858 | Joel Eric Vander Lugt | Physical Therapist | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2011-10-10 |
| 1639372709 | Forrest Q Pecha | Specialist/Technologist | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2007-06-07 |
| 1518978337 | Alejandro A Homaechevarria | Family Medicine | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2006-08-10 |
| 1780694182 | Erik J Heggland | Orthopaedic Surgery | 1109 W Myrtle St, Suite 200, Boise, ID 83702-6970 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124637095 | Rick Charles Loveland | Physical Therapist | 10390 W Sawtail St, Boise, ID 83714-9508 | 2020-07-27 |
| 1558979138 | Chloe Coleman | Physical Therapist | 1961 S Broadway Ave, Boise, ID 83706-4201 | 2020-07-20 |
| 1811512650 | Lauren Olivia Vangorp | Physical Therapist | 5418 N Eagle Rd Ste 170, Boise, ID 83713-0999 | 2020-06-08 |
| 1366089153 | Shelby Mcgibney | Physical Therapist | 1835 Wildwood St, Boise, ID 83713-5146 | 2019-11-29 |
| 1417441270 | James Liaw | Physical Therapist | 1109 W Myrtle St Ste 220, Boise, ID 83702-6975 | 2018-06-15 |
| 1720570997 | Ron Giles | Physical Therapist | 2999 N Lakeharbor Ln Ste 120, Boise, ID 83703-6291 | 2018-06-04 |
| 1841701976 | Pamela Brown | Physical Therapist | 2910 W Hazel St, Boise, ID 83703-5939 | 2017-10-16 |
| 1013436641 | Renew Manual Physical Therapy Pllc | Physical Therapist | 7444 W Saxton Dr # K101, Boise, ID 83714-1316 | 2017-09-14 |
| 1609391952 | Janice Lynette Fountain | Physical Therapist | 4110 N La Fontana Way, Boise, ID 83702-1559 | 2017-08-08 |
| 1134643885 | Ian David Tracy | Physical Therapist | 1175 E Parkcenter Blvd Ste 104, Boise, ID 83706-6752 | 2017-08-02 |
| Find all providers in BOISE | ||||
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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.