David Lynn Andersen, R.P.T., L.A.T, A.T.C

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-322 Issued in ID

Practice address

363 Tyra Dr
Idaho Falls, ID 83401-4437

Phone

(208) 681-2525

NPI assigned

Apr 16, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Rocky Mountain Physical Therapy PLLC

  • Physical Therapist
  • Blackfoot, ID
  • NPI 1538172648
  NPD (past)

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1265657001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 TYRA DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014437",
            "telephone_number": "208-681-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 TYRA DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014437",
            "telephone_number": "208-681-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "DAVID",
        "middle_name": "LYNN",
        "credential": "R.P.T., L.A.T, A.T.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-322",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ID",
            "license": "AT-004",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0043961",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• American Heritage Charter School
• Amplify Optometry of America PLLC
• John L Andary, M.D.
• Sterling Don Andelin, PHD
• Bryce Wade Andersen, NP-C
• Joe A Andersen, LPC
• Mikayla Andersen
• Carol V Anderson, PHD
• Cola Anderson
• David Ray Anderson, MD

• 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 11, 2025; 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.