Benjamin Waldron, DPT
Individual provider Active NPI Physical Therapist · Shelley, ID
NPI 1538084553 · NPPES record last updated Aug 10, 2026
Key facts
- NPI
- 1538084553
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2581928 (ID)
- Practice address
- 186 W Pine St
Shelley, ID 83274-1235 - Phone
- (208) 932-0108
- NPI assigned
- Aug 10, 2026
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cruz Therapy Services | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2581928 | ID | Yes |
Addresses
Primary practice location
186 W Pine St
Shelley, ID 83274-1235
Mailing address
186 W Pine St
Shelley, ID 83274-1235
Phone (208) 932-0108
Other providers in Shelley, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.