Matthew McKee, PT, DPT
Individual provider Active NPI Physical Therapist · Rupert, ID
NPI 1154976207 · NPPES record last updated Aug 6, 2019
Key facts
- NPI
- 1154976207
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 6470 (ID)
- Practice address
- 1224 8TH St Ste a
Rupert, ID 83350-1527 - Phone
- (208) 436-9016
- Fax
- (208) 436-4922
- NPI assigned
- Aug 6, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern Idaho Therapy Services
Practice addresses (Care Compare)
1224 8TH St a
Rupert, ID 83350-1527
Phone (208) 436-9015
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190926003353 | ID | Practitioner - Physical Therapist in Private Practice | 2567792914 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6470 | ID | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Idaho Therapy Services | Physical Therapist | Current |
Accepting new patients |
Locations
1224 8th St
#A
Rupert, ID 83350
Phone (208) 436-9015
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6470 | ID | Yes |
Addresses
Primary practice location
1224 8TH St Ste a
Rupert, ID 83350-1527
Mailing address
1224 8TH St Ste a
Rupert, ID 83350-1527
Phone (208) 436-9016
Other providers in Rupert, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.