Inspire Functional Rehabilitation and Fitness

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

INSPIRE FUNCTIONAL REHABILITATION AND FITNESS

Practice address

1286 E Tuttle St
Meridian, ID 83646-5932

Phone

(209) 969-2426

NPI assigned

May 27, 2022

Last updated

Jul 19, 2022By 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

Mary Johnson, P.T.NPI 1598432718

Title

Owner/Therapist

Phone

(209) 969-2426

Specialties & licenses 1

Addresses

Other names 1

• INSPIRE Functional Rehabilitation and Fitness Former legal business name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Johnson, PT

  • Physical Therapist
  • Meridian, ID
  • NPI 1598432718
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658188800000",
    "number": "1366180465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1286 E TUTTLE ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465932",
            "telephone_number": "801-872-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1286 E TUTTLE ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465932",
            "telephone_number": "209-969-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSPIRE FUNCTIONAL REHABILITATION AND FITNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-27",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "209-969-2426",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "simplepractice.com",
            "affiliation": "N",
            "endpointDescription": "EMR service",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EMR service",
            "address_1": "1286 E Tuttle St",
            "city": "Meridian",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836465932",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "INSPIRE Functional Rehabilitation and Fitness",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.