Lake Health & Rehab, LLC
Organization Active NPI Physical Therapist · Lakeside, MT
NPI 1538417233 · NPPES record last updated Dec 9, 2022
Key facts
- NPI
- 1538417233
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- LAKE HEALTH & REHAB, LLC
- Practice address
- 306 Stoner Loop Ste 3
Lakeside, MT 59922-8601 - Phone
- (406) 844-0744
- Fax
- (406) 844-0759
- NPI assigned
- Aug 28, 2012
- Organization subpart
- Yes
- Parent organization (as reported)
- HEALTH & REHAB SOLUTIONS, INC.
Authorized official
- Name
- Mr. Blaine Stimac, PT
- Title
- Managing Member
- Phone
- (406) 756-1128
Practitioners 16
-
Joshua Christoferson, DPT
-
Devin R Hallstrom, PT, DPT
-
Megan L Henry, DPT
-
Wyatt C Jordan, DPT
-
Christopher M Leck, DPT
-
Elise K Slichter, DPT
-
Tristan Tollas, DPT
-
Joshua Paul Grubb, PT, DPT
-
Kade Brantingham, PT, DPT
-
Luke Demolli, DPT
-
Jacob H Groh, DPT
-
Melanie Gilbert Hunt, DPT
-
Abigail Zaremba, PT, DPT
-
Honani Polequaptewa, PT, MPT, CEEAA, LMT
-
Blaine Stimac, PT,MS
-
Randall R Hite, PT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121227000245 | MT | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 6901059963 |
Receives reassigned benefits from 13 practitioners Practice locations: Bigfork, MT; Lakeside, MT |
National Provider Directory
Locations
8111 MT Highway 35
Ste 9
Bigfork, MT 59911
Phone (406) 857-2995
218 Sportsman Ln
Ste 2
Bigfork, MT 59911
Phone (406) 420-2350
218 Sportsman Ln
#2
Bigfork, MT 59911
306 Stoner Loop
Ste 5
Lakeside, MT 59922
Phone (406) 837-3255
103 Whitewater Pl
Ste D
Polson, MT 59860
Phone (406) 883-8101
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
306 Stoner Loop Ste 3
Lakeside, MT 59922-8601
Mailing address
PO Box 5718
Kalispell, MT 59903-5718
Phone (406) 756-0134
Other names
- Professional Therapy Associates
Other providers in Lakeside, MT
- Richard Xavier Fleming
- Gwen Gates
- Colton Bill Hoffenbacker
- Kalispell Regional Medical Center Inc
- Karel K Kearl
- Lakeside Chiropractic Clinic PC
- Lakeside Pharmacy LLC
- Lakeside Qru, Inc
- Abby Gene Lambeth
- Grace Matheson
All providers in Lakeside, MT · Physical Therapist in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.