Preferred Physical Therapy, P.a.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PREFERRED PHYSICAL THERAPY, P.A.

Practice address

126 E Main St
Grangeville, ID 83530-2211

Phone

(208) 406-5195

Fax

(208) 983-0114

NPI assigned

Mar 2, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jeremy Thomas Pettinger, MPT

Title

President

Phone

(208) 406-5195

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447389093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 E MAIN ST",
            "address_2": "PO BOX 327",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835302211",
            "telephone_number": "208-406-5195",
            "fax_number": "208-983-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E MAIN ST",
            "city": "GRANGEVILLE",
            "state": "ID",
            "postal_code": "835302211",
            "telephone_number": "208-406-5195",
            "fax_number": "208-983-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED PHYSICAL THERAPY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETTINGER",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-406-5195",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jeremy Thomas Pettinger, MPT
• Nicolette Phillips, LCSW
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• Physical Therapy Clinic/Center in Grangeville, ID
• Providers in Grangeville, ID by specialty
• Physical Therapy Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.