Active NPI
Phares Briggs Horman, P.T.
- Physical Therapist
- Ammon, ID
National Provider Identifier
1013087576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-727
- Practice address
- 3456 E 17TH St
Suite 130
Ammon, ID 83406-6757 - Phone
- (208) 523-0030
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-727 | ID | Primary |
| Physical Therapist | 225100000X | 2305202579 | VA | |
| Physical Therapist | 225100000X | CP061972T | DC |
Addresses
Primary practice location
3456 E 17TH St
Suite 130
Ammon, ID 83406-6757
Mailing address
3456 E 17TH St
Suite 130
Ammon, ID 83406-6757
Phone (208) 523-0030
Other practice location 1
8316 Arlington Blvd Ste 640
Fairfax, VA 22031-5216
Phone (703) 272-8340
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TD207 | Other | ID | BLUE CROSS INDIVIDUAL # |
| 000010152190 | Other | ID | BLUE SHIELD INDIV. NUMBER |
| 000010152186 | Other | ID | BLUE SHIELD GROUP NUMBER |
| 807304100 | Medicaid | ID | |
| 805331400 | Medicaid | ID | |
| 8M467 | Other | ID | BLUE CROSS GROUP NUMBER |
Other names 1
- Briggs Horman
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-727 | ID | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Performance Therapy Services P C | Physical Therapist | Current | Accepting new patients |
Locations
3456 E 17th St
Ste 130
Ammon, ID 83406
Phone (208) 523-0030
2323 Coronado St
Idaho Falls, ID 83404
Phone (208) 522-5230
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Ammon, ID
- NPI 1003898974
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788912000000",
"number": "1013087576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3456 E 17TH ST",
"address_2": "SUITE 130",
"city": "AMMON",
"state": "ID",
"postal_code": "834066757",
"telephone_number": "208-523-0030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3456 E 17TH ST",
"address_2": "SUITE 130",
"city": "AMMON",
"state": "ID",
"postal_code": "834066757",
"telephone_number": "208-523-0030"
}
],
"practiceLocations": [
{
"address_1": "8316 Arlington Blvd Ste 640",
"address_purpose": "LOCATION",
"city": "Fairfax",
"state": "VA",
"postal_code": "220315216",
"country_code": "US",
"telephone_number": "703-272-8340",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HORMAN",
"first_name": "PHARES",
"middle_name": "BRIGGS",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2026-09-09",
"certification_date": "2026-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-727",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305202579",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DC",
"license": "CP061972T",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS INDIVIDUAL #",
"identifier": "TD207",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD INDIV. NUMBER",
"identifier": "000010152190",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD GROUP NUMBER",
"identifier": "000010152186",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807304100",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805331400",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS GROUP NUMBER",
"identifier": "8M467",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BRIGGS",
"last_name": "HORMAN",
"credential": "P.T.",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Ammon, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.