Individual provider Active NPI

Don Jay Garner, PTA

  • Physical Therapy Assistant
  • Rexburg, ID
National Provider Identifier
1336726348
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA1778 Issued in ID
Practice address
36 Winn Dr Ste 100
Rexburg, ID 83440-5277
Phone
(208) 356-0174
Fax
(208) 356-0176
NPI assigned
Mar 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA1778 ID Primary

Addresses

Primary practice location

36 Winn Dr Ste 100
Rexburg, ID 83440-5277

Mailing address

36 Winn Dr Ste 100
Rexburg, ID 83440-5277
Phone (208) 356-0174

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rexburgrehab@hotmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA1778IDMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
PMD Therapies, PLLC CurrentSince Mar 28, 2021 Accepting new patients
Mountain View Hospital LLC PastSince Mar 28, 2021 Accepting new patients

Locations

36 Winn Dr
#100
Rexburg, ID 83440
Phone (208) 356-0174

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1336726348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 WINN DR STE 100",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405277",
            "telephone_number": "208-356-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 WINN DR STE 100",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405277",
            "telephone_number": "208-356-0174",
            "fax_number": "208-356-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARNER",
        "first_name": "DON",
        "middle_name": "JAY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ID",
            "license": "PTA1778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rexburgrehab@hotmail.com",
            "affiliation": "N",
            "address_1": "36 Winn Dr Ste 100",
            "city": "Rexburg",
            "state": "ID",
            "country_code": "US",
            "postal_code": "834405277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

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