Individual provider Active NPI

David Watson Hillman, PT

  • Physical Therapist
  • Post Falls, ID
National Provider Identifier
1205916848
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT912 Issued in ID
Practice address
1132 E Polston Ave
Post Falls, ID 83854-6045
Phone
(208) 777-7800
Fax
(208) 777-9209
NPI assigned
Oct 17, 2006
Last updated
Jul 18, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT912 ID
Physical Therapist 225100000X PT912 ID Primary

Addresses

Primary practice location

1132 E Polston Ave
Post Falls, ID 83854-6045

Mailing address

1132 E Polston Ave
Post Falls, ID 83854-6045
Phone (208) 777-7800

Other identifiers 6

IdentifierTypeStateIssuer
000010024489OtherIDREGENCE BLUE SHIELD
GROUP HEALTHOtherID7624
T2516OtherIDBLUE CROSS
650011684OtherIDRAILROAD MEDICARE
1134149941MedicaidID
101976OtherWAWASHINGTON L&I

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100908000158 ID Practitioner - Physical Therapist in Private Practice 3274522214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
River City Physical TherapyGroup PAC ID 4688662083, 4 clinicians

Practice addresses (Care Compare)

1132 E Polston Ave
Post Falls, ID 83854-6045
Phone (208) 777-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT912IDMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
River City Physical Therapy Physical Therapist CurrentSince Sep 14, 1995 Accepting new patients
Scott Randklev Physical Therapy P.a. Physical Therapist PastSince Mar 16, 2021 Accepting new patients

Locations

370 E Kathleen Ave
Ste 500
Coeur D Alene, ID 83815
Phone (208) 292-1372

1132 E Polston Ave
Post Falls, ID 83854
Phone (208) 777-7800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1205916848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1132 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838546045",
            "telephone_number": "208-777-7800",
            "fax_number": "208-777-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838546045",
            "telephone_number": "208-777-7800",
            "fax_number": "208-777-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLMAN",
        "first_name": "DAVID",
        "middle_name": "WATSON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": "PT912",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010024489",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "7624",
            "identifier": "GROUP HEALTH",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "T2516",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650011684",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134149941",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON L&I",
            "identifier": "101976",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.