Individual provider Active NPI

Bryant Belnap, PT

  • Physical Therapist
  • Idaho Falls, ID
National Provider Identifier
1619917200
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-343 Issued in ID
Practice address
3345 Merlin Dr
Suite 100
Idaho Falls, ID 83404-7405
Phone
(208) 522-4481
Fax
(208) 522-6137
NPI assigned
Jun 8, 2006
Last updated
Apr 9, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-343 ID Primary

Addresses

Primary practice location

3345 Merlin Dr
Suite 100
Idaho Falls, ID 83404-7405

Mailing address

3345 Merlin Dr
Suite 100
Idaho Falls, ID 83404-7405
Phone (208) 522-4481

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-343IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tahi Physical Therapy PLLC Physical Therapist PastSince Dec 1, 2014 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1619917200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3345 MERLIN DR",
            "address_2": "SUITE 100",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047405",
            "telephone_number": "208-522-4481",
            "fax_number": "208-522-6137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3345 MERLIN DR",
            "address_2": "SUITE 100",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047405",
            "telephone_number": "208-522-4481",
            "fax_number": "208-522-6137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELNAP",
        "first_name": "BRYANT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.