Channing Physical Therapy PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

CHANNING PHYSICAL THERAPY PC

Practice address

2570 Channing Way
Idaho Falls, ID 83404-7515

Phone

(208) 529-8005

NPI assigned

Apr 22, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Meisha Adams

Title

Billing Manager

Phone

(208) 529-8005

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1306064910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047515",
            "telephone_number": "208-529-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047515",
            "telephone_number": "208-529-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANNING PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-22",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "MEISHA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "208-529-8005",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805633700",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC OF IDAHO GROUP ID#",
            "identifier": "T-097-3",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS OF IDAHO GROUP ID#",
            "identifier": "39012",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Aaron Chambers, DDS
• Jon F Champlin, CRNA
• Kenna Chancey, LCSW
• Brynlee Chandler, COTA/L
• Channing Physical Therapy & Associates LLC (Channing Physical Therapy)
• Channing Way Dental Care
• Justin Chapman, ATC,LAT
• Madison Chapman
• Charlotte Ackerman LCSW PLLC
• Melissa Charlton

• Specialist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Specialist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.