Adam Michael Borg, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-2370 Issued in ID

Practice address

1172 W Hayden Ave
Hayden, ID 83835-8700

Phone

(208) 762-3332

Fax

(208) 762-4268

NPI assigned

Jun 26, 2008

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shellman Inc PAGroup PAC ID 4981592938, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Shellman Inc PA

  • Physical Therapist
  • Coeur D Alene, ID
  • NPI 1326050253
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236297600000",
    "number": "1093977589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 N LAKEWOOD DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142634",
            "telephone_number": "208-664-8194",
            "fax_number": "208-667-1847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1172 W HAYDEN AVE",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358700",
            "telephone_number": "208-762-3332",
            "fax_number": "208-762-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORG",
        "first_name": "ADAM",
        "middle_name": "MICHAEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2009-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-2370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Aaron Bloom, DMD
• Bethany Bloomer
• Body Tech Massage & Wellness
• Rachael Susan Boelke, MAS-4345 MA 61150034
• Shannon Bohanek
• Jessica Borges, LM
• Roberta Boyd, LPC
• Carolyn P Brainard, LMP
• Jennifer Dawn Brakeman, LM
• Brave Connections Mental Health Therapy, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.