Active NPI
Ben Wardell
- Physical Therapist
- Post Falls, ID
National Provider Identifier
1497104459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 1132 E Polston Ave
Post Falls, ID 83854-6045 - Phone
- (208) 777-7800
- Fax
- (208) 777-9209
- NPI assigned
- Jun 9, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
1132 E Polston Ave
Post Falls, ID 83854-6045
Mailing address
1132 E Polston Ave
Post Falls, ID 83854-6045
Phone (208) 777-7800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134149941 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465430400000",
"number": "1497104459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1132 E POLSTON AVE",
"city": "POST FALLS",
"state": "ID",
"postal_code": "838546045",
"telephone_number": "208-777-7800",
"fax_number": "208-777-9209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1132 E POLSTON AVE",
"city": "POST FALLS",
"state": "ID",
"postal_code": "838546045",
"telephone_number": "208-777-7800",
"fax_number": "208-777-9209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARDELL",
"first_name": "BEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-06-09",
"last_updated": "2016-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1134149941",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Post Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.