Brett J Homstad, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-2868 Issued in ID

Practice address

134 E Idaho Ave
Homedale, ID 83628-5003

Phone

(208) 337-3254

Fax

(208) 337-3264

NPI assigned

Jul 14, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rock and Armor Physical Therapy and Sports Performance, LLCGroup PAC ID 9931328994, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rock and Armor Physical Therapy and Sports Performance, LLC

  • Physical Therapist
  • Meridian, ID
  • NPI 1689089971

  ID, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Rehabauthority, LLC

  • Multi-Specialty Clinic/Center
  • Grand Forks, ND
  • NPI 1730159690

  ID, Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310601600000",
    "number": "1083902878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2176 E FRANKLIN RD",
            "address_2": "SUITE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429024",
            "telephone_number": "208-288-1155",
            "fax_number": "208-288-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 E IDAHO AVE",
            "city": "HOMEDALE",
            "state": "ID",
            "postal_code": "836285003",
            "telephone_number": "208-337-3254",
            "fax_number": "208-337-3264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMSTAD",
        "first_name": "BRETT",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-2868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse Tyler Cook, DPT
• Reagan E Fernley, PTA
• Stacy Carol Fisher, CMT
• Homedale Healthcare, Inc.
• Homedale Rural Fire Protection District
• Idaho Frontier Wellness
• Idaho Street Medical Clinic
• Idaho Street Medical Clinic
• Identistry PLLC
• William Guy Jeppe Jr., DMD

• All providers in Homedale, ID
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.