Individual provider Active NPI

Anna Rose Owens, PTA

  • Physical Therapy Assistant
  • Coeur D Alene, ID
National Provider Identifier
1548076417
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
8653 Issued in ID
Practice address
3896 N Schreiber Way
Coeur D Alene, ID 83815-8362
Phone
(208) 666-6665
NPI assigned
Dec 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 8653 ID Primary

Addresses

Primary practice location

3896 N Schreiber Way
Coeur D Alene, ID 83815-8362

Mailing address

3896 N Schreiber Way
Coeur D Alene, ID 83815-8362
Phone (208) 666-6665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8653IDMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Sports and Orthopedic Physical Therapy LLC CurrentSince Dec 8, 2024 Accepting new patients

Locations

3896 N Schreiber Way
Coeur D Alene, ID 83815
Phone (208) 666-6665

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1548076417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3896 N SCHREIBER WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158362",
            "telephone_number": "208-666-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3896 N SCHREIBER WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838158362",
            "telephone_number": "208-666-6665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "ANNA",
        "middle_name": "ROSE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ID",
            "license": "8653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.