Streamline Sports Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-2831 Issued in ID

Legal business name

STREAMLINE SPORTS PHYSICAL THERAPY PC

Practice address

335 E Lewis St Ste 10
Pocatello, ID 83201-6408

Phone

(208) 269-2360

Fax

(208) 550-3256

NPI assigned

Aug 8, 2017

Last updated

Sep 20, 2021By 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

Blaire Zikratch-Clayson, PTNPI 1538453360

Title

Owner/PT

Phone

(208) 269-2360

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Atlas Bracing LLC

  • Customized Equipment (DME)
  • Pocatello, ID
  • NPI 1548950173
  NPPES parent name

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.

• Blaire M Zikratch-Clayson, DPT

  • Physical Therapist
  • Pocatello, ID
  • NPI 1538453360
  Medicare reassignment Care Compare group NPD Authorized official
• Andrew Blake Goode, DPT

  • Physical Therapist
  • Pocatello, ID
  • NPI 1447698113
  Medicare reassignment Care Compare group NPD
• Michael Arnold, DPT

  • Physical Therapist
  • Pocatello, ID
  • NPI 1922673383
  Medicare reassignment NPD
• Kenneth Blair Reed, DPT,PT

  • Physical Therapist
  • Pocatello, ID
  • NPI 1518582212
  Medicare reassignment NPD

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632096000000",
    "number": "1073038378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 E LEWIS ST STE 10",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016408",
            "telephone_number": "208-269-2360",
            "fax_number": "208-550-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 E LEWIS ST STE 10",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016408",
            "telephone_number": "208-269-2360",
            "fax_number": "208-550-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STREAMLINE SPORTS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-08",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A",
        "authorized_official_last_name": "ZIKRATCH-CLAYSON",
        "authorized_official_first_name": "BLAIRE",
        "authorized_official_title_or_position": "OWNER/PT",
        "authorized_official_telephone_number": "208-269-2360",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-2831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brayden Lee Stouse
• Eric Michael Stradley
• Joshua Strait, DPT
• Abby Straley
• Mattie Strand
• Brock Stringam, DMD
• Sari D Stringfield, DPT
• Brittany Strong, NP
• Jamie Strong
• Lisa Stuban, MASSAGE THERAPIST

• Physical Therapist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; 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.