Michael Rupp

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-3511 Issued in ID

Practice address

2640 Channing Way
Idaho Falls, ID 83404-7517

Phone

(208) 522-2248

Fax

(208) 522-2463

NPI assigned

Apr 6, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fremont Physical Therapy PLLCGroup PAC ID 9739655663, 2 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.

• Fremont Physical Therapy PLLC

  • Physical Therapist
  • Saint Anthony, ID
  • NPI 1639034184
  Medicare reassignment Care Compare group NPD
• Rupp Physical Therapy

  • Physical Therapist
  • Saint Anthony, ID
  • NPI 1588337927
  NPD Authorized official
• Norco Inc.

  • Durable Medical Equipment & Medical Supplies
  • Blanding, UT
  • NPI 1780546028
  NPD (past)

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

{
    "created_epoch": "1396742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1184042129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047517",
            "telephone_number": "208-522-2248",
            "fax_number": "208-522-2463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047517",
            "telephone_number": "208-522-2248",
            "fax_number": "208-522-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPP",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-06",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "ID",
            "license": "PT-3511",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-3511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan William Rozack, FNP-C
• Molly Grace Ruffner
• Kevin Ruhnau
• Anna Ruiz-Gruwell, NP-C
• Brooke Sue Rupe, COTA/L
• Russell Guymon Orthodontics, PA
• Daric J Russell, DO
• Sarah Lynn Russell, BSW, LMSW
• Lisa J Russom, LSW
• Orin Kelley Ryan, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; 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.