John Henry Allen Roberts

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-9710 Issued in ID

Practice address

3100 S Woodruff Ave
Idaho Falls, ID 83404-8310

Phone

(208) 523-8879

NPI assigned

May 23, 2024

Last updated

May 23, 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

Ellis Physical Therapy and Associates LLCGroup PAC ID 0244660710, 3 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.

• Ellis Physical Therapy and Associates LLC

  • Physical Therapy Clinic/Center
  • Idaho Falls, ID
  • NPI 1821628645

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Ellis Physical Therapy P a

  • Physical Therapist
  • Idaho Falls, ID
  • NPI 1518203249
  NPD

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1508605957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048310",
            "telephone_number": "208-523-8879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048310",
            "telephone_number": "208-523-8879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JOHN HENRY",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-9710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert J. Lee, M.D., PC
• Eric Deloy Roberts, MSPT
• Jacob Benjamin Roberts, DPT
• Jane C Roberts, MS, SLP-CCC
• Jared Roberts
• Katie Jo Roberts
• Maryia Lindsay Roberts
• Barbara A Robinson, MSW
• Brian J. Robinson, D.C.
• Kjersten Robinson

• Physical Therapist in Idaho Falls, ID
• Providers in Idaho Falls, 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 23, 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.