I Can PT LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-2550 Issued in ID

Legal business name

I CAN PT LLC

Practice address

1626 Wells Ave
Suite 105
Meridian, ID 83642-4524

Phone

(208) 789-0200

Fax

(208) 288-2784

NPI assigned

Oct 9, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Heather J Henderson, DPTNPI 1396070538

Title

Ceo

Phone

(208) 789-0200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• I CAN PT Doctors of Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 4

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

• Heather J Henderson, DPT

  • Physical Therapist
  • Meridian, ID
  • NPI 1396070538
  Medicare reassignment Care Compare group Authorized official
• Charles Guy Riddle, DPT

  • Physical Therapist
  • Meridian, ID
  • NPI 1366536609
  Medicare reassignment Care Compare group
• Jarrod Stephen Altrogge, DPT

  • Physical Therapist
  • Meridian, ID
  • NPI 1457089211
  Medicare reassignment NPD
• Ryan Hall, DPT

  • Physical Therapist
  • Meridian, ID
  • NPI 1053003053
  Medicare reassignment NPD

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423180800000",
    "number": "1194129817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 WELLS AVE",
            "address_2": "SUITE 105",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424524",
            "telephone_number": "208-789-0200",
            "fax_number": "208-288-2784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 WELLS AVE",
            "address_2": "SUITE 105",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424524",
            "telephone_number": "208-789-0200",
            "fax_number": "208-288-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I CAN PT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-09",
        "last_updated": "2015-02-06",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-789-0200",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-2550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1194129817",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "I CAN PT Doctors of Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grace Yeeun Hwang, OTR/L
• Lisa K Hyde, RNFA
• Tonya R Hylton, MS CCC SLP
• Chelsey Faye Hymas, FNP, CNM
• Hytech Repair Inc.
• Id Specialty Dental Services, PLLC
• Idaho Anesthesia Partners LLC
• Idaho Anti-Trafficking Coalition
• Idaho Arthritis & Osteoporosis Center PC
• Idaho Bariatric and Metabolic Institute L.L.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.