Moscow Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

MOSCOW PHYSICAL THERAPY, LLC

Practice address

1174 Alturas Drive
Suite 2
Moscow, ID 83843

Phone

(208) 375-0666

Fax

(208) 375-2996

NPI assigned

Sep 25, 2020

Organization subpart

No

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

Authorized official

Name

Shellie M McCarthy

Title

Vice President

Phone

(208) 314-5904

Specialties & licenses 1

Addresses

Other names 1

• Peak Physical Therapy Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Peak Physical Therapy P C

  • Physical Therapist
  • Boise, ID
  • NPI 1073551560

  Member Of

  NPD member

Locations

Practitioners 2

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

• Thomas M Miller, PHYSICAL THERAPIST

  • Physical Therapist
  • Moscow, ID
  • NPI 1518072131
  NPD
• Thanh-Truc Nguyen

  • Physical Therapist
  • Mountain Home, ID
  • NPI 1851125850
  NPD (past)

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670976000000",
    "number": "1033726880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 ALTURAS DRIVE",
            "address_2": "SUITE 2",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "83843",
            "telephone_number": "208-375-0666",
            "fax_number": "208-375-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 ALTURAS DRIVE",
            "address_2": "SUITE 2",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "83843",
            "telephone_number": "208-375-0666",
            "fax_number": "208-375-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSCOW PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-25",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "MCCARTHY",
        "authorized_official_first_name": "SHELLIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "208-314-5904"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peak Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Peak Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Motherwise Midwifery Service, LLC
• Ruth Tadios Munie, PHARMD
• Arista A Munsel, DCP
• Mignonne Nyabarishi Muragizi
• Michele Murphy

• Physical Therapy Clinic/Center in Moscow, ID
• Providers in Moscow, ID by specialty
• Physical Therapy Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.