Nathan Todd Lundberg, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT7243 Issued in ID

Practice address

535 N Locust Grove Rd Ste 170
Meridian, ID 83642-9379

Phone

(208) 917-2660

Fax

(208) 917-2630

NPI assigned

May 25, 2021

Sex

Male

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rock and Armor Physical Therapy and Sports Performance, LLCGroup PAC ID 9931328994, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Rock and Armor Physical Therapy and Sports Performance, LLC

  • Physical Therapist
  • Meridian, ID
  • NPI 1689089971
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1316512015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 N LOCUST GROVE RD STE 170",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429379",
            "telephone_number": "208-917-2660",
            "fax_number": "208-917-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 N LOCUST GROVE RD STE 170",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429379",
            "telephone_number": "208-917-2660",
            "fax_number": "208-917-2630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 W 53rd St",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "ID",
            "postal_code": "837143501",
            "country_code": "US",
            "telephone_number": "208-375-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNDBERG",
        "first_name": "NATHAN",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT7243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "7243",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.rockandarmor.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "535 N Locust Grove Rd Ste 170",
            "city": "Meridian",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836429379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.rockandarmor.com",
            "affiliation": "N",
            "endpointDescription": "online website",
            "address_1": "535 N Locust Grove Rd Ste 170",
            "city": "Meridian",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836429379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chace Ludwig
• Jason Scott Ludwig, D.O.
• Nancy Luna, BA
• Kimball T. Lundahl, D.C.
• Joshua Eric Lundberg, MD, FAAFP
• Brian Lunt, PHARMD
• Cameron Lutz, DPT
• Sidney Jo Luvisi
• Lux Wellness LLC
• Lux Wellness LLC

• Physical Therapist in Meridian, ID
• Providers in Meridian, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.