Individual provider Active NPI

Jeffrey A Thomason, PT

  • Physical Therapist
  • Caldwell, ID
National Provider Identifier
1538253752
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 832 Issued in ID
Practice address
3410 Blaine St
#101
Caldwell, ID 83605
Phone
(208) 455-9826
Fax
(208) 459-1626
NPI assigned
Oct 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 832 ID Primary

Addresses

Primary practice location

3410 Blaine St
#101
Caldwell, ID 83605

Mailing address

PO Box 711185
Salt Lake City, UT 84171
Phone (801) 942-3311

Other identifiers 1

IdentifierTypeStateIssuer
0027023000MedicaidID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250820002670 ID Practitioner - Physical Therapist in Private Practice 5890605687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Land Rehabilitation LLCGroup PAC ID 9234048745, 207 clinicians

Practice addresses (Care Compare)

4623 Enterprise Way
Caldwell, ID 83605-6764
Phone (208) 455-4231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 832IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Land Rehabilitation LLC Physical Therapist CurrentSince Aug 1, 2025 Accepting new patients

Locations

4623 Enterprise Way
Caldwell, ID 83605
Phone (208) 455-4231

1800 Flandro Dr
Ste 190
Pocatello, ID 83202
Phone (208) 233-2248

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538253752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 711185",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84171",
            "telephone_number": "801-942-3311",
            "fax_number": "801-942-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 BLAINE ST",
            "address_2": "#101",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "83605",
            "telephone_number": "208-455-9826",
            "fax_number": "208-459-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMASON",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT 832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0027023000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.