NPIMap

Organization Active NPI

Cruz Therapy Services

Doing business as Shelley Physical Therapy & Fitness Center

  • Physical Therapist
  • Shelley, ID
National Provider Identifier
1063126209
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CRUZ THERAPY SERVICES
Doing business as
Shelley Physical Therapy & Fitness Center
Practice address
186 W Pine St
Shelley, ID 83274-1235
Phone
(208) 680-4787
NPI assigned
Jan 12, 2023
Last updated
Mar 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Authorized official

Name
Joel Cruz, DPTNPI 1003382276
Title
Owner
Phone
(208) 932-0108

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

186 W Pine St
Shelley, ID 83274-1235

Mailing address

400 Grant St
Blackfoot, ID 83221-2119
Phone (208) 680-4787

Other names 1

  • Shelley Physical Therapy & Fitness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230808000125 ID Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9133593106 Receives reassigned benefits from 2 practitioners
Practice locations: Shelley, ID

National Provider Directory

National Provider Directory

Locations

186 W Pine St
Shelley, ID 83274
Phone (208) 680-4787

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1063126209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 GRANT ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832212119",
            "telephone_number": "208-680-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 W PINE ST",
            "city": "SHELLEY",
            "state": "ID",
            "postal_code": "832741235",
            "telephone_number": "208-680-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRUZ THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-12",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-932-0108",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shelley Physical Therapy & Fitness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shelley Physical Therapy & Fitness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelley, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.