Cruz Therapy Services
Organization Active NPI Physical Therapist · Shelley, ID
NPI 1063126209 · NPPES record last updated Mar 12, 2025
Key facts
- NPI
- 1063126209
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- CRUZ THERAPY SERVICES
- Practice address
- 186 W Pine St
Shelley, ID 83274-1235 - Phone
- (208) 680-4787
- NPI assigned
- Jan 12, 2023
- Organization subpart
- No
Authorized official
- Name
- Joel Cruz, DPT
- Title
- Owner
- Phone
- (208) 932-0108
Practitioners 4
-
Joel Cruz, PT
-
Justin Roderick Usher, PT, DPT
-
Betty Christina Jaques, OTRL
-
Benjamin Waldron, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
Locations
186 W Pine St
Shelley, ID 83274
Phone (208) 680-4787
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
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
- Shelley Physical Therapy & Fitness Center
Other providers in Shelley, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.