Stanley Ryan Peck, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT6264 Issued in ID

Practice address

1053 Eastland Dr
Twin Falls, ID 83301-6747

Phone

(208) 736-9011

NPI assigned

Aug 1, 2019

Last updated

Aug 1, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bodybalance PT Twin Falls LLCGroup PAC ID 0143456814, 6 clinicians

BBPT IncGroup PAC ID 7315935913, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• BBPT Inc

  dba Body Balance Physical Therapy

  • Physical Therapist
  • Gooding, ID
  • NPI 1811951841
  Medicare reassignment Care Compare group NPD
• Bodybalance PT Twin Falls LLC

  dba BodyBalance Physical Therapy

  • Physical Therapy Clinic/Center
  • Twin Falls, ID
  • NPI 1043657828

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1548815079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "478 LOIS ST",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833017636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1053 EASTLAND DR",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016747",
            "telephone_number": "208-736-9011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1053 Eastland Dr",
            "address_purpose": "LOCATION",
            "city": "Twin Falls",
            "state": "ID",
            "postal_code": "833016747",
            "country_code": "US",
            "telephone_number": "208-736-9011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "423 Idaho St",
            "address_purpose": "LOCATION",
            "city": "Gooding",
            "state": "ID",
            "postal_code": "833301258",
            "country_code": "US",
            "telephone_number": "208-736-9011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECK",
        "first_name": "STANLEY",
        "middle_name": "RYAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-01",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT6264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Thomas Payne, L. C. S. W.
• Rose Maire Payne
• Peak Medical of Idaho LLC (Twin Falls Center)
• Alexis Pearson, LCSW
• Cindy L Pearson, BC-HIS
• Tina M. Peer, N.P.
• Travis Pehrson, APRN-CNP
• Nicholas J Perius, PA
• Logan Perkins, DO
• Michael Jake Perrin, NP

• Physical Therapist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.