Organization Active NPI

Tall Family Physical Therapy PLLC

  • Physical Therapist
  • Idaho Falls, ID
National Provider Identifier
1194667535
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
TALL FAMILY PHYSICAL THERAPY PLLC
Practice address
3630 S 25TH E Ste 4
Idaho Falls, ID 83404-4993
Phone
(208) 970-4833
NPI assigned
Apr 6, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Authorized official

Name
Dr. Ethan Aldon Tall, DPTNPI 1497696371
Title
Owner
Phone
(208) 970-4833

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

3630 S 25TH E Ste 4
Idaho Falls, ID 83404-4993

Mailing address

3630 S 25TH E Ste 4
Idaho Falls, ID 83404-4993
Phone (208) 970-4833

National Provider Directory

National Provider Directory

Locations

3630 S 25th E
Ste 4
Idaho Falls, ID 83404
Phone (208) 970-4833

Practitioners & affiliated clinicians

Practitioners 1

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": "1775433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782086400000",
    "number": "1194667535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 S 25TH E STE 4",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044993",
            "telephone_number": "208-970-4833",
            "fax_number": "208-439-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 S 25TH E STE 4",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044993",
            "telephone_number": "208-970-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALL FAMILY PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-06",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A",
        "authorized_official_last_name": "TALL",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_middle_name": "ALDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-970-4833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.