NPIMap

Organization Active NPI

Physio Therapeutics, PLLC

  • Physical Therapist
  • Pocatello, ID
National Provider Identifier
1306514369
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSIO THERAPEUTICS, PLLC
Practice address
4141 Poleline Rd Ste a
Pocatello, ID 83202-4904
Phone
(208) 242-8617
Fax
(833) 608-2470
NPI assigned
Sep 2, 2021
Last updated
Sep 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Authorized official

Name
Daniel M Barclay, PTNPI 1376752279
Title
Owner / PT
Phone
(801) 372-4622

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

4141 Poleline Rd Ste a
Pocatello, ID 83202-4904

Mailing address

9626 N Ridgewood Rd
Pocatello, ID 83201-9023
Phone (801) 372-4622

National Provider Directory

National Provider Directory

Locations

4141 Poleline Rd
Ste A
Pocatello, ID 83202
Phone (208) 242-8617

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630540800000",
    "number": "1306514369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9626 N RIDGEWOOD RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832019023",
            "telephone_number": "801-372-4622",
            "fax_number": "833-608-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 POLELINE RD STE A",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832024904",
            "telephone_number": "208-242-8617",
            "fax_number": "833-608-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIO THERAPEUTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A",
        "authorized_official_last_name": "BARCLAY",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER / PT",
        "authorized_official_telephone_number": "801-372-4622",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.