Hilary O'Bannon, DPT
Individual provider Active NPI Physical Therapist · Homedale, ID
NPI 1598085904 · NPPES record last updated Jun 8, 2010
Key facts
- NPI
- 1598085904
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT-2701 (ID)
- Practice address
- 134 E Idaho Ave
Homedale, ID 83628-5003 - Phone
- (208) 337-3254
- Fax
- (208) 337-3264
- NPI assigned
- Jun 8, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-2701 | ID | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabauthority, LLC | Physical Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-2701 | ID | Yes |
Addresses
Primary practice location
134 E Idaho Ave
Homedale, ID 83628-5003
Mailing address
2176 E Franklin Rd
Suite 100
Meridian, ID 83642-9024
Phone (208) 288-1155
Other providers in Homedale, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.