Individual provider Active NPI

Jeffrey R Taylor, DPT

  • Physical Therapist
  • Meridian, ID
National Provider Identifier
1346501962
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-2983 Issued in ID
Practice address
2056 S. Eagle Rd
Meridian, ID 83642-2462
Phone
(208) 906-8469
NPI assigned
May 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-2983 ID Primary

Addresses

Primary practice location

2056 S. Eagle Rd
Meridian, ID 83642-2462

Mailing address

2056 S. Eagle Rd
Meridian, ID 83642-2462
Phone (208) 906-8469

Other identifiers 1

IdentifierTypeStateIssuer
1639365323MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120619000623 ID Practitioner - Physical Therapist in Private Practice 3971767120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Pursuit Physical Therapy LLCGroup PAC ID 0648709089, 2 clinicians

Practice addresses (Care Compare)

2056 S Eagle Rd
Meridian, ID 83642-6707
Phone (208) 906-8469

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-2983IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pursuit Physical Therapy LLC Physical Therapist CurrentSince Dec 11, 2024 Accepting new patients

Locations

2056 S Eagle Rd
Meridian, ID 83642
Phone (208) 495-5202

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1346501962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2056 S. EAGLE RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422462",
            "telephone_number": "208-906-8469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2056 S. EAGLE RD",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422462",
            "telephone_number": "208-906-8469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JEFFREY",
        "middle_name": "R",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-30",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-2983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639365323",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.