Trey Braedon Lane, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-7506 Issued in ID

Practice address

130 S Midland Blvd
Nampa, ID 83686-2601

Phone

(208) 461-5057

NPI assigned

Nov 2, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Altitude Physical Therapy IncGroup PAC ID 0244267029, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Altitude Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Caldwell, ID
  • NPI 1619045309
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1487319612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S MIDLAND BLVD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862601",
            "telephone_number": "208-461-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S MIDLAND BLVD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836862601",
            "telephone_number": "208-461-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "TREY",
        "middle_name": "BRAEDON",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-7506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Lamana, BCBA, DHSC
• Brandy Nicole Lamb, LMSW
• Paola F Lamberti, MSW
• Brian Lambson, LMP
• Nancy Lamm, NBC-HIS
• Kjersti Lang
• George Langfield, PH.D
• Jasmine Emma Laniado
• Conner Lanier, PA
• Brenna Joy Lankow

• Physical Therapist in Nampa, ID
• Providers in Nampa, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.

Verify at the official NPI Registry.