Teton Physical Therapy, Inc

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT623 Issued in ID

Legal business name

TETON PHYSICAL THERAPY, INC

Practice address

2037 E 17TH St
Idaho Falls, ID 83404-6430

Phone

(208) 529-3355

Fax

(208) 529-9581

NPI assigned

Feb 26, 2010

Last updated

Jul 21, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Russell G Griffeth, MPTNPI 1841359866

Title

President

Phone

(208) 529-3355

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Russell Gary Griffeth, MPT

  • Physical Therapist
  • Idaho Falls, ID
  • NPI 1841359866
  Medicare reassignment NPD Authorized official
• Adam Beaderstadt, PTA

  • Physical Therapy Assistant
  • Idaho Falls, ID
  • NPI 1730935420
  Medicare reassignment NPD
• Tiffany Heather Maxwell, PTA

  • Physical Therapy Assistant
  • Idaho Falls, ID
  • NPI 1063268753
  Medicare reassignment NPD
• Jeffrey Robert Girton, PT

  • Physical Therapist
  • Rigby, ID
  • NPI 1972666139
  NPD (past)
• William Brent Griffeth

  • Occupational Therapist
  • Idaho Falls, ID
  • NPI 1588727879
  NPD (past)
• Joseph Monte Wight, DPT

  • Orthopedic Physical Therapist
  • Idaho Falls, ID
  • NPI 1851645634
  NPD (past)

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1053633313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2037 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046430",
            "telephone_number": "208-529-3355",
            "fax_number": "208-529-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2037 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046430",
            "telephone_number": "208-529-3355",
            "fax_number": "208-529-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETON PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-26",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "GRIFFETH",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-529-3355",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "ID",
            "license": "PT623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002714400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teton MRI of Idaho Falls
• Teton Nuclear Medicine Service LLC
• Teton Obstetrics and Gynecology PA
• Teton Oms (Snake River Surgical)
• Teton Outpatient, LLC
• Teton Plastic Surgery
• Teton Radiology Diagnostic a Series of Teton Group Enterprise (Teton Radiology)
• Teton Radiology Diagnostic, LLC
• Teton Surgical Specialties PLLC (Teton Hand Surgery)
• Teton Women's Health Center

• Orthopedic Physical Therapist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Orthopedic Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.