Lon Miguel Egbert, PT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1686 Issued in ID

Practice address

128 5TH Ave W
Jerome, ID 83338-1863

Phone

(208) 324-3090

Fax

(208) 324-3093

NPI assigned

Nov 10, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lon M. Egbert, P.C.Group PAC ID 8224132477, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lon M. Egbert, P.C.

  dba Jerome Physical Therapy & Sports Medicine Clinic

  • Physical Therapist
  • Jerome, ID
  • NPI 1265527725
  Medicare reassignment Care Compare group NPD Authorized official
• Southern Idaho Therapy Services

  • Physical Therapist
  • Rupert, ID
  • NPI 1275698490
  NPD (past)

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1437130952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 EAGLE RIDGE DR",
            "city": "WENDELL",
            "state": "ID",
            "postal_code": "833553340",
            "telephone_number": "208-536-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 5TH AVE W",
            "city": "JEROME",
            "state": "ID",
            "postal_code": "833381863",
            "telephone_number": "208-324-3090",
            "fax_number": "208-324-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGBERT",
        "first_name": "LON",
        "middle_name": "MIGUEL",
        "credential": "PT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT1686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010140741",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "T6962",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul A Dickinson, CRNA
• Matthew Duersch, M.D.
• Marylin Eacker, LSW
• Brakeal Edwards
• David Edwards, LPC, LPCC
• Newell Tyler Elison, DDS
• Tammy Emerson, MS CCC SLP
• Curtis Phillip Emery, RT (R)(CT)
• David J Erickson, DO
• Kyana Evalyn

• Physical Therapist in Jerome, ID
• Providers in Jerome, 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 13, 2026; 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.