Organization Active NPI

Current Physical Therapy Meridian

  • Physical Therapy Assistant
  • Meridian, ID
National Provider Identifier
1508647900
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Legal business name
CURRENT PHYSICAL THERAPY MERIDIAN
Practice address
1020 N. Hickory Ave Unit 3 Ste 115
Meridian, ID 83642
Phone
(208) 314-4988
Fax
(208) 296-7921
NPI assigned
Oct 11, 2023
Last updated
Oct 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Authorized official

Name
Nicholas Cole Hartley, DPTNPI 1699166843
Title
Member
Phone
(541) 212-0337

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X Primary

Addresses

Primary practice location

1020 N. Hickory Ave Unit 3 Ste 115
Meridian, ID 83642

Mailing address

119 S. Valley Dr. Ste a #178
Nampa, ID 83686
Phone (208) 800-1619

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240105003844 ID Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8820449689 Receives reassigned benefits from 4 practitioners
Practice locations: Meridian, ID

National Provider Directory

National Provider Directory

Locations

1020 N Hickory Ave
Ste 115
Meridian, ID 83642
Phone (208) 314-4988

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1508647900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 S. VALLEY DR. STE A #178",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "83686",
            "telephone_number": "208-800-1619",
            "fax_number": "208-296-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N. HICKORY AVE UNIT 3 STE 115",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-314-4988",
            "fax_number": "208-296-7921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CURRENT PHYSICAL THERAPY MERIDIAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "HARTLEY",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "COLE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "541-212-0337",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.