Vista Physical Therapy, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

VISTA PHYSICAL THERAPY, PLLC

Practice address

1615 Midway Dr
Ammon, ID 83406-6799

Phone

(208) 529-1715

NPI assigned

Mar 1, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Keegan David Parmer, DPTNPI 1871029660

Title

Owner

Phone

(208) 529-1715

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keegan Parmer, DPT

  • Orthopedic Physical Therapist
  • Ammon, ID
  • NPI 1871029660
  Medicare reassignment Care Compare group NPD Authorized official
• Eric Hunter, PT,DPT, ATC

  • Physical Therapist
  • Great Falls, MT
  • NPI 1588079784

  ID

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617321600000",
    "number": "1033704101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 S EMERY LN",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014674",
            "telephone_number": "208-529-1715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 MIDWAY DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066799",
            "telephone_number": "208-529-1715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A",
        "authorized_official_last_name": "PARMER",
        "authorized_official_first_name": "KEEGAN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-529-1715",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Klett Vance, M.D.
• Jordan Dee Vander Does
• Debra Velasquez, LMFT
• Celeste Vieira
• Isabel Ruby Vincent
• Nancy Lee Vollmer, M.A.
• Rachelle Lanae Waite, RBT
• Wal-Mart Stores, Inc
• Walgreen Co
• Heike Wallin, FNP

• Physical Therapist in Ammon, ID
• Providers in Ammon, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.