Canfield Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1767 Issued in ID

Legal business name

CANFIELD PHYSICAL THERAPY

Practice address

402 W Canfield Ave
Ste 5
Coeur D Alene, ID 83815-7784

Phone

(208) 659-0750

Fax

(208) 772-0246

NPI assigned

Apr 30, 2011

Last updated

Jun 10, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lori-Ann Bluemer-Tierney, MPT

Title

President

Phone

(208) 659-0750

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1304121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307664000000",
    "number": "1346531969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3138",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838353138",
            "telephone_number": "208-659-0750",
            "fax_number": "208-772-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W CANFIELD AVE",
            "address_2": "STE 5",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838157784",
            "telephone_number": "208-659-0750",
            "fax_number": "208-772-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANFIELD PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-30",
        "last_updated": "2011-06-10",
        "status": "A",
        "authorized_official_last_name": "BLUEMER-TIERNEY",
        "authorized_official_first_name": "LORI-ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-659-0750",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT1767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Campbell, RPH
• David Michael Campbell, DSOM, LAC
• Katrina Ann Campbell
• Samantha Campbell, ARNP
• Canfield Family Medical Group LLC (Canfield Family Medicine)
• Canfield PT PLLC
• Daniel Edward Cannon, MD
• Danielle Elaine Cannon, LCSW
• Michelle Nicole Cano-Keighley, ARNP
• Canopy Village Inc.

• Physical Therapist in Coeur d'Alene, ID
• Providers in Coeur d'Alene, 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 10, 2011; 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.