NPIMap

Organization Active NPI

Pierce Physical Therapy and Sports Rehab LLC

  • Physical Therapist
  • Meridian, ID
National Provider Identifier
1578076519
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-3309 Issued in ID
Legal business name
PIERCE PHYSICAL THERAPY AND SPORTS REHAB LLC
Practice address
4771 N Summit Way Ste 100
Meridian, ID 83646-5017
Phone
(208) 629-0656
Fax
(208) 617-3077
NPI assigned
Nov 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Authorized official

Name
Dr. Brett Pierce, DPTNPI 1740614569
Title
Owner, Physical Therapist
Phone
(208) 371-2610

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT-3309 ID Primary

Addresses

Primary practice location

4771 N Summit Way Ste 100
Meridian, ID 83646-5017

Mailing address

4771 N Summit Way Ste 100
Meridian, ID 83646-5017
Phone (208) 629-0656

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180201002259 ID Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6305106857 Receives reassigned benefits from 4 practitioners
Practice locations: Meridian, ID

National Provider Directory

National Provider Directory

Locations

1532 W Cayuse Creek Dr
Meridian, ID 83646
Phone (208) 898-1382

4771 N Summit Way
#100
Meridian, ID 83646
Phone (208) 629-0656

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1578076519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4771 N SUMMIT WAY STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465017",
            "telephone_number": "208-629-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4771 N SUMMIT WAY STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465017",
            "telephone_number": "208-629-0656",
            "fax_number": "208-617-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIERCE PHYSICAL THERAPY AND SPORTS REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "208-371-2610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-3309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.