Benjamin Anderson, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-9030 Issued in ID

Practice address

4922 Yellowstone Ave Ste J
Chubbuck, ID 83202-2360

Phone

(208) 237-1882

Fax

(208) 904-2990

NPI assigned

May 24, 2024

Last updated

May 24, 2024By the provider in NPPES

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Specialized Physical Therapy PLLCGroup PAC ID 7719211754, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Specialized Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Pocatello, ID
  • NPI 1215381181

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Flicker Physical Therapy LLC

  • Physical Therapist
  • Chubbuck, ID
  • NPI 1144504812
  NPD
• Physio Therapeutics, PLLC

  • Physical Therapist
  • Pocatello, ID
  • NPI 1306514369
  NPD (past)

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

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1508605874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4922 YELLOWSTONE AVE STE J",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022360",
            "telephone_number": "208-237-1882",
            "fax_number": "208-904-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4922 YELLOWSTONE AVE STE J",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022360",
            "telephone_number": "208-237-1882",
            "fax_number": "208-904-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BENJAMIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-9030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advanced Heallhcare Solutions LLC (Physicians Immediate Care Center)
• Amy Alder, PHARMD
• Hannah Allen, PARAPROFESSIONAL
• Jeffery William Allen
• Brandi Allerdings, PT
• Taylor Anna Anderson, MS, CCC-SLP
• Trinity Anderson, DPT
• Randall Apgood, LPC
• Apria Healthcare LLC
• Tara Arocho, NP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.

Verify at the official NPI Registry.