Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kendra W Ickes

Individual provider Physical Therapist · NPI 1902533078

Kendra W Ickes is a Physical Therapist in Private Practice in Boise, Idaho. Qualified in 2022, 4 years ago. Practices with Therapeutic Associates Inc, a 322-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2022
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Practice location Address checks out

1520 W State St Ste 210
Boise, ID 83702-4026
Phone: (208) 336-8433
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1902533078
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 8, 2022
Last updated in NPPESAugust 8, 2022
Certification dateAugust 8, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Therapeutic Associates Inc — 322 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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