Active NPI
Tifani Waechtler, PT
- Physical Therapist
- Preston, ID
National Provider Identifier
1144313610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- RPT-1129
- Practice address
- 43 North 100 East
Preston, ID 83263 - Phone
- (208) 852-0116
- Fax
- (208) 852-0116
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | RPT-1129 | ID | Primary |
Addresses
Primary practice location
43 North 100 East
Preston, ID 83263
Mailing address
3445 West 2000 North
Dayton, ID 83232
Phone (208) 747-3418
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPT-1129 | ID | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Winward Physical Therapy | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Preston, ID
- NPI 1205920899
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144313610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3445 WEST 2000 NORTH",
"city": "DAYTON",
"state": "ID",
"postal_code": "83232",
"telephone_number": "208-747-3418",
"fax_number": "208-852-0116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 NORTH 100 EAST",
"city": "PRESTON",
"state": "ID",
"postal_code": "83263",
"telephone_number": "208-852-0116",
"fax_number": "208-852-0116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAECHTLER",
"first_name": "TIFANI",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "RPT-1129",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Preston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.