Tri-City Physical Therapy, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

TRI-CITY PHYSICAL THERAPY, P.C.

Practice address

215 N. Whitley Drive
Suite 1
Fruitland, ID 83619-2706

Phone

(208) 452-6366

Fax

(208) 452-6399

NPI assigned

Jan 9, 2007

Organization subpart

No

Name

Mr. Cody Dee Stephens, P.T.NPI 1174598593

Title

Owner/President

Phone

(208) 452-6366

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Tri-City Physical Therapy, P.C.

  • Specialist
  • Weiser, ID
  • NPI 1477573756

  O20040902000857

  Same enrollment

Organizations that report the same tax identification number in the National Provider Directory.

• Tri-City Physical Therapy, P.C.

  • Specialist
  • Weiser, ID
  • NPI 1477573756
  NPD tax ID

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cody D. Stephens, M.P.T.

  • Specialist
  • Fruitland, ID
  • NPI 1174598593
  NPD Authorized official
• Craig L Hamann, D.P.T.

  • Specialist
  • Fruitland, ID
  • NPI 1942248596
  NPD
• Janeil M Heaton, M.P.T.

  • Specialist
  • Fruitland, ID
  • NPI 1245205665
  NPD
• Logan Bake

  • Orthopedic Physical Therapist
  • Ontario, OR
  • NPI 1407265838
  NPD
• Kevin Brett Nattress, P.T.

  • Specialist
  • Fruitland, ID
  • NPI 1982679304
  NPD (past)
• Alan W Keller, PT

  • Physical Therapist
  • Ogden, UT
  • NPI 1588671374
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Tax ID family

Advanced Physical Therapy (2 organizations share this tax ID)

Locations

• Tir-City Physical Therapy Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 21, 2013.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369094400000",
    "number": "1093864282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N. WHITLEY DRIVE",
            "address_2": "SUITE 1",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192706",
            "telephone_number": "208-452-6366",
            "fax_number": "208-452-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N. WHITLEY DRIVE",
            "address_2": "SUITE 1",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192706",
            "telephone_number": "208-452-6366",
            "fax_number": "208-452-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITY PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2013-05-21",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "CODY",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "208-452-6366",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "RPT550",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806639200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tir-City Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Thad W Wilkey, PA

• All providers in Fruitland, ID
• Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.