Mountain West Sport and Spine Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

MOUNTAIN WEST SPORT AND SPINE PHYSICAL THERAPY LLC

Practice address

649 N Cliff Creek LN
Meridian, ID 83642-1071

Phone

(253) 334-0178

NPI assigned

Jan 29, 2024

Organization subpart

No

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

Authorized official

Name

Hannah Cappetto, PTA

Title

Owner/Clinic Manager

Phone

(253) 334-0178

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 3

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

• Sean O'Kelley, DPT

  • Physical Therapist
  • Bellevue, WA
  • NPI 1710429840

  ID

  Medicare reassignment NPD
• Hannah Messner, PTA

  • Physical Medicine & Rehabilitation Physician
  • Kirkland, WA
  • NPI 1598124547
  NPD
• Jessica Tyler, PT, DPT, CERT. DN

  • Physical Therapist
  • Meridian, ID
  • NPI 1063342632
  NPD (past)

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

{
    "created_epoch": "1706486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1295597763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1826 N HENDERSON AVE",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466466",
            "telephone_number": "253-334-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 N CLIFF CREEK LN",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421071",
            "telephone_number": "253-334-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN WEST SPORT AND SPINE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-29",
        "last_updated": "2024-07-11",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "CAPPETTO",
        "authorized_official_first_name": "HANNAH",
        "authorized_official_title_or_position": "OWNER/CLINIC MANAGER",
        "authorized_official_telephone_number": "253-334-0178",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mountain Valley Counseling LLC
• Mountain View Pointe Dental
• Mountain View Surgery Center
• Mountain West Medical Services PLLC
• Mountain West Spine LLC
• Hannah Lynn Mower
• Rachael Ann Mower, RN
• Molly Moyer, COUI
• Mary L. Muckelroy, LCSW
• Kristi L Mueller, LCSW

• Physical Therapy Clinic/Center in Meridian, ID
• Providers in Meridian, ID by specialty
• Physical Therapy Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.