NPIMap

Organization Active NPI

Ponderosa Pediatric Therapy LLC

  • Occupational Therapist
  • Post Falls, ID
National Provider Identifier
1053062018
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
PONDEROSA PEDIATRIC THERAPY LLC
Practice address
2738 N Ivy LN
Post Falls, ID 83854-5459
Phone
(360) 839-1697
NPI assigned
Jan 11, 2022
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Cortney HuffNPI 1720499320
Title
Owner
Phone
(360) 839-1697

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

2738 N Ivy LN
Post Falls, ID 83854-5459

Mailing address

2738 N Ivy LN
Post Falls, ID 83854-5459

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 11, 2022.

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641859200000",
    "number": "1053062018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2738 N IVY LN",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2738 N IVY LN",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545459",
            "telephone_number": "360-839-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONDEROSA PEDIATRIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A",
        "authorized_official_last_name": "HUFF",
        "authorized_official_first_name": "CORTNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-839-1697"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.