Active NPI
Lone Peak Physical Therapy, Inc
- Physical Therapist
- Butte, MT
National Provider Identifier
1477082709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- LONE PEAK PHYSICAL THERAPY, INC
- Practice address
- 3745 Harrison Ave Ste C
Butte, MT 59701-6814 - Phone
- (406) 494-7050
- Fax
- (406) 494-1424
- NPI assigned
- Jun 9, 2017
- Organization subpart
- Yes
- Parent organization
- LONE PEAK PHYSICAL THERAPY, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John C Boersma, MPT, OCS
- Title
- Owner/President
- Phone
- (406) 522-7488
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary | ||
| Occupational Therapist | 225X00000X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X |
Addresses
Primary practice location
3745 Harrison Ave Ste C
Butte, MT 59701-6814
Mailing address
PO Box 11629
Bozeman, MT 59719-1629
Phone (406) 522-7488
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477678969 | Medicaid | MT |
National Provider Directory
National Provider Directory- Part of
- Lone Peak Phys Therapy Inc
Locations
3745 Harrison Ave
Ste C
Butte, MT 59701
Phone (406) 494-7050
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496966400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1553040000000",
"number": "1477082709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 11629",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597191629",
"telephone_number": "406-522-7488",
"fax_number": "406-522-7487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3745 HARRISON AVE STE C",
"city": "BUTTE",
"state": "MT",
"postal_code": "597016814",
"telephone_number": "406-494-7050",
"fax_number": "406-494-1424"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LONE PEAK PHYSICAL THERAPY, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LONE PEAK PHYSICAL THERAPY, INC",
"enumeration_date": "2017-06-09",
"last_updated": "2019-03-20",
"status": "A",
"authorized_official_last_name": "BOERSMA",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "OWNER/PRESIDENT",
"authorized_official_telephone_number": "406-522-7488",
"authorized_official_credential": "MPT, OCS"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1477678969",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Butte, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.