Casondra Dawn Pahis, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-4045 Issued in ID

Practice address

620 S Woodruff Ave
Idaho Falls, ID 83401-5299

Phone

(208) 419-3408

NPI assigned

Jun 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Snake River Physical Therapy Specialists LLCGroup PAC ID 2365871472, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Snake River Physical Therapy Specialists LLC

  • Physical Therapist
  • Idaho Falls, ID
  • NPI 1174156814
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1306226337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834015299",
            "telephone_number": "208-419-3408",
            "fax_number": "208-529-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834015299",
            "telephone_number": "208-419-3408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3125 Valencia Dr",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834047575",
            "country_code": "US",
            "telephone_number": "208-529-3332",
            "fax_number": "208-529-3336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAHIS",
        "first_name": "CASONDRA",
        "middle_name": "DAWN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-04",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-4045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO STATE LICENSE",
            "identifier": "PT-4045",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Padron Counseling Services, LLC
• Padron Counseling Services, LLC
• Jorge Padron, CADC
• Merrill Page
• Michaelina S Page, RN
• Pain Specialists of Idaho
• Pain Specialists of Idaho
• Sandy Palma
• Emily Lou Palmer, M.S. CCC-SLP
• Jill Palmer, MFT

• 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 Apr 5, 2021; 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.