NPIMap

Organization Active NPI

Parkside Physical Therapy, LLC

  • Physical Therapist
  • West Yellowstone, MT
National Provider Identifier
1407362049
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PARKSIDE PHYSICAL THERAPY, LLC
Practice address
235 Firehole Ave
West Yellowstone, MT 59758-1573
Phone
(406) 646-7068
Fax
(406) 646-7069
NPI assigned
Dec 19, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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

Authorized official

Name
Jennifer L Jordan, P.TNPI 1174571954
Title
Provider/Owner
Phone
(406) 646-7068

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

235 Firehole Ave
West Yellowstone, MT 59758-1573

Mailing address

PO Box 1573
West Yellowstone, MT 59758-1573
Phone (406) 646-7068

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513641600000",
    "number": "1407362049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1573",
            "city": "WEST YELLOWSTONE",
            "state": "MT",
            "postal_code": "597581573",
            "telephone_number": "406-646-7068",
            "fax_number": "406-646-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 FIREHOLE AVE",
            "city": "WEST YELLOWSTONE",
            "state": "MT",
            "postal_code": "597581573",
            "telephone_number": "406-646-7068",
            "fax_number": "406-646-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2017-12-19",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "406-646-7068",
        "authorized_official_credential": "P.T"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Yellowstone, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.