Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ZACKERY LEE SANDERS
NPI 1649912510
Physical Medicine & Rehabilitation - Sports Medicine in Boise, ID

Q: What is Zackery Sanders's NPI number?

The NPI number for Zackery Sanders is 1649912510. It was assigned to this individual provider in the NPPES registry on April 11, 2022.

Q: What is Zackery Sanders's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation, specializing in Sports Medicine, with taxonomy code 2081S0010X.

Q: When was this NPI record last updated?

The NPPES record for Zackery Sanders was last updated on August 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 11, 2022PECOS Enrolled

2619 W FAIRVIEW AVE, BOISE, ID 83702(208) 706-9300(208) 489-4300 Get Directions Write a Review

NPPES record last updated: August 27, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Aug 27, 2026, Apr 11, 2022 (2 updates tracked since 2022).

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About Zackery Lee Sanders NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ZACKERY LEE SANDERS (NPI 1649912510) is an individual sports medicine provider in Boise, Idaho, licensed in Idaho (5381229) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649912510

Entity TypeIndividualMale

Primary Taxonomy2081S0010X

Provider Legal NameZACKERY LEE SANDERS

Location Address2619 W FAIRVIEW AVEBoise, ID 83702-6722

Mailing Address190 E Bannock StBoise, ID 83712-6241

Phone(208) 706-9300

Fax(208) 489-4300

Sole ProprietorNo

Enumeration DateApril 11, 2022

Last NPPES UpdateAugust 27, 20262 updates tracked since enumeration

NPPES CertifiedAugust 27, 2026

✔ NPI 1649912510 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & Rehabilitation · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2081S0010X

License✔ Licensed in ID · 5381229

Definition

A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise.

2619 W FAIRVIEW AVE, Boise, ID 83702

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Zackery Lee Sanders is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER LYNN RICE LAT, ATC

Specialist/Technologist (Athletic Trainer)