Grant Wade, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1481014 Issued in ID

Practice address

645 E State St Ste 101
Eagle, ID 83616-5915

Phone

(208) 939-9594

Fax

(208) 939-9828

NPI assigned

Feb 23, 2026

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 2026

Medicare assignment

May accept Medicare assignment

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.

• Foothills Physical Therapy PA

  • Specialist
  • Meridian, ID
  • NPI 1851457675
  NPD

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

{
    "created_epoch": "1771804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1316891971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 E STATE ST STE 101",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165915",
            "telephone_number": "208-939-9594",
            "fax_number": "208-939-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 E STATE ST STE 101",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165915",
            "telephone_number": "208-939-9594",
            "fax_number": "208-939-9828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "GRANT",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-23",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "1481014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vibrant Physical Therapy & Wellness
• Cathleen Vicini, MFT, PSY.D.
• Paul Charles Villaret, PHARMD
• Abram Paul Vore, AUD
• Christopher Waag, PHARMD
• Joshua James Wageman, PA-C, DPT, CSCS
• Kassidy Diane Wagner, BCBA
• Laila Wahdan, DACCHM, MTCM, L.AC.
• Deborah Anne Waite, MACCC-SLP
• Alex Wald

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.