NPI age
1 years
Enumerated 2024-07-11
● Active Type 2 · Organization
Idaho Sport Massage Llc
Idaho Sport Massage Llc is 1 of 798 massage therapist organizations in Idaho.
Primary specialty
Massage Therapist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Cervantes
Owner
Last NPPES update
2024-10-24
Source: monthly bulk 2026-05
How this organization compares
Across 798 active massage therapist providers in Idaho.
NPI age
1 years
↓ 6 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2024 → 2026
2024-07Enumerated in NPPES
2024
2026
Where they practice
Primary practice location
675 Yellowstone Ave # 1
Pocatello, ID 832014511
Mailing address
4846 Hiram Ave
Chubbuck, ID 832023018
Authorized official
Mindy Cervantes
Owner
📞 4355809461
Individual providers at this organization
4 individual providers on file at this primary practice address.
- Jonah Heyneman, PT, DPT Physical Therapist NPI 1164040655
- Tyler Sebring, PT, DPT Physical Therapist NPI 1275109522
- Troy Siler Physical Therapist NPI 1861997421
- Abigail Warner, PT, DPT Physical Therapist NPI 1487446910
Specialties
-
Massage Therapist PrimaryAn individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Idaho Sport Massage
-
Idaho Sport Massage
Practice context
Multi-provider organization. 4 individual providers on file at this primary address.
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Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.