NPIMap

Organization Active NPI

RS Physical Therapy PC

Doing business as Rebound Physical Therapy

  • Physical Therapist
  • Meridian, ID
National Provider Identifier
1154969533
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RS PHYSICAL THERAPY PC
Doing business as
Rebound Physical Therapy
Practice address
2204 E Lanark St Ste 100
Meridian, ID 83642-5916
Phone
(208) 908-7907
Fax
(208) 908-7935
NPI assigned
Dec 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Authorized official

Name
Mr. Randall Langley, PTNPI 1598852139
Title
Owner
Phone
(208) 939-3332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2204 E Lanark St Ste 100
Meridian, ID 83642-5916

Mailing address

457 S Fitness PL Ste 100
Eagle, ID 83616-6568
Phone (208) 939-3332

Other names 1

  • Rebound Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200316001985 ID Part B Supplier - Physical/Occupational Therapy Group in Private Practice 9931537412 Receives reassigned benefits from 3 practitioners
Practice locations: Meridian, ID

National Provider Directory

National Provider Directory

Locations

2204 E Lanark St
Ste 100
Meridian, ID 83642
Phone (208) 908-7907

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605139200000",
    "number": "1154969533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 S FITNESS PL STE 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166568",
            "telephone_number": "208-939-3332",
            "fax_number": "208-939-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 E LANARK ST STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425916",
            "telephone_number": "208-908-7907",
            "fax_number": "208-908-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-16",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A",
        "authorized_official_last_name": "LANGLEY",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-939-3332",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rebound Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rebound Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; 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.