Full Potential Physical Therapy, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT-1243 Issued in ID

Legal business name

FULL POTENTIAL PHYSICAL THERAPY, PLLC

Practice address

450 Thain Rd Ste a
Lewiston, ID 83501-5300

Phone

(208) 816-8836

Fax

(208) 621-2995

NPI assigned

Feb 26, 2017

Organization subpart

No

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

Authorized official

Name

Saker Ravee Medavarapu, MPT

Title

Physical Therapist

Phone

(208) 816-8836

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1488067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1477093334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 THAIN RD STE A",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835015300",
            "telephone_number": "208-816-8836",
            "fax_number": "208-746-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 THAIN RD STE A",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835015300",
            "telephone_number": "208-816-8836",
            "fax_number": "208-621-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL POTENTIAL PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-26",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "MEDAVARAPU",
        "authorized_official_first_name": "SAKER",
        "authorized_official_middle_name": "RAVEE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "208-816-8836",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "ID",
            "license": "PT-1243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fraley & Associates, PLLC
• Lynn Alison Fraley, PHD
• Lloyd Paul Levi Frasier, DPT
• Emma French, LPC, NCC
• Kaytie Friesen, BSW, BIS, IP
• Codi Fuller, D.C.
• Steve Fuller
• Rebecca L. Fulton, MD
• Cody Funk
• Julie Len Funke, FNP

• Physical Therapy Clinic/Center in Lewiston, ID
• Providers in Lewiston, 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 Nov 29, 2023; 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.