NPIMap

Organization Active NPI

Tri-City Physical Therapy, P.C.

  • Specialist
  • Weiser, ID
National Provider Identifier
1477573756
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
TRI-CITY PHYSICAL THERAPY, P.C.
Practice address
275 E 7TH St
Weiser, ID 83672-2303
Phone
(208) 549-1008
Fax
(208) 549-1396
NPI assigned
Jul 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Authorized official

Name
Mr. Cody Dee Stephens, P.T.NPI 1174598593
Title
Owner/President
Phone
(208) 452-6366

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

275 E 7TH St
Weiser, ID 83672-2303

Mailing address

275 E 7TH St
Weiser, ID 83672-2303
Phone (208) 549-1008

Other identifiers 1

IdentifierTypeStateIssuer
804093200MedicaidID

Other names 1

  • Advanced Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040902000857 ID Part B Supplier - Clinic/Group Practice 7517933484 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: Fruitland, ID; Weiser, ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Advanced Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369094400000",
    "number": "1477573756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 E 7TH ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836722303",
            "telephone_number": "208-549-1008",
            "fax_number": "208-549-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 E 7TH ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836722303",
            "telephone_number": "208-549-1008",
            "fax_number": "208-549-1396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITY PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-05-21",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "CODY",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "208-452-6366",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804093200",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weiser, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.