Active NPI
Abigail Mackenzie Nordquist, DPT, PT
- Physical Therapist
- Meridian, ID
National Provider Identifier
1477396232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-9045
- Practice address
- 1739 S Jade Way Ste 110
Meridian, ID 83642-5898 - Phone
- (208) 207-5454
- NPI assigned
- Jun 18, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-9045 | ID | Primary |
Addresses
Primary practice location
1739 S Jade Way Ste 110
Meridian, ID 83642-5898
Mailing address
1739 S Jade Way Ste 110
Meridian, ID 83642-5898
Phone (208) 207-5454
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID, MT
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
150 E Spruce St
Suite a
Missoula, MT 59802-4504
Phone (406) 549-0064
2175 N Whitley Dr
Fruitland, ID 83619-2132
Phone (208) 452-7197
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-9045 | ID | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Current Physical Therapy LLC | Physical Therapist | Current | Accepting new patients |
Locations
2175 N Whitley Dr
Fruitland, ID 83619
Phone (208) 452-0303
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Fruitland, ID
- NPI 1518478734
-
- Physical Therapist
- Missoula, MT
- NPI 1306858642
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1477396232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1739 S JADE WAY STE 110",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836425898",
"telephone_number": "208-207-5454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1739 S JADE WAY STE 110",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836425898",
"telephone_number": "208-207-5454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORDQUIST",
"first_name": "ABIGAIL",
"middle_name": "MACKENZIE",
"credential": "DPT, PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-18",
"last_updated": "2024-06-18",
"certification_date": "2024-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-9045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.