Active NPI
Brandon J Pollard, DPT
- Physical Therapist
- Twin Falls, ID
National Provider Identifier
1356822704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-6982
- Practice address
- 243 Cheney Dr W
Twin Falls, ID 83301-4277 - Phone
- (208) 329-7667
- Fax
- (208) 329-7669
- NPI assigned
- Aug 23, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3854 | NV | |
| Physical Therapist | 225100000X | PT-6982 | ID | Primary |
Addresses
Primary practice location
243 Cheney Dr W
Twin Falls, ID 83301-4277
Mailing address
1444 Falls Ave E Ste 401
Twin Falls, ID 83301-3408
Phone (208) 736-2574
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3854 | Other | NV | STATE OF NEVADA BOARD OF PHYSICAL THERAPY |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-6982 | ID | MD | Physical Therapist |
| 3854 | NV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586995200000",
"number": "1356822704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1444 FALLS AVE E STE 401",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833013408",
"telephone_number": "208-736-2574",
"fax_number": "208-736-2594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "243 CHENEY DR W",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833014277",
"telephone_number": "208-329-7667",
"fax_number": "208-329-7669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLLARD",
"first_name": "BRANDON",
"middle_name": "J",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-23",
"last_updated": "2020-04-16",
"certification_date": "2020-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "3854",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-6982",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF NEVADA BOARD OF PHYSICAL THERAPY",
"identifier": "3854",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.