Primary Therapy Source LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

PRIMARY THERAPY SOURCE LLC

Practice address

254 River Vista PL
Twin Falls, ID 83301-3006

Phone

(208) 734-7333

Fax

(208) 734-8350

NPI assigned

Oct 23, 2008

Organization subpart

Yes

Parent organization

PRIMARY THERAPY SOURCE LLCAs reported in NPPES

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

Authorized official

Name

Jan Yingst, PT

Title

Owner

Phone

(208) 734-7333

Specialties & licenses 1

Addresses

Tax ID family

Primary Therapy Source LLC2 organizations share this tax ID, including this one

Part of

Primary Therapy Source LLC

Other organizations with this tax ID 1

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

• Primary Therapy Source LLC

  • Occupational Therapist
  • Twin Falls, ID
  • NPI 1235385659
  NPD tax ID

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224720000000",
    "number": "1114170024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 RIVER VISTA PL",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013006",
            "telephone_number": "208-734-7333",
            "fax_number": "208-734-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 RIVER VISTA PL",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013006",
            "telephone_number": "208-734-7333",
            "fax_number": "208-734-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY THERAPY SOURCE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIMARY THERAPY SOURCE LLC",
        "enumeration_date": "2008-10-23",
        "last_updated": "2008-10-23",
        "status": "A",
        "authorized_official_last_name": "YINGST",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-734-7333",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy A Prestin, LCPC
• Daniel G Preucil, M.D.
• Jennifer L Preucil, M.D.
• Janice Preuit
• Primary Therapy Source LLC
• Primary Therapy Source LLC
• Primary Therapy Source, Inc
• Primary Therapy Source, LLC
• Dustin Dakota Prince, DO
• Teresa Prine, PT

• Speech-Language Pathologist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.