NPIMap

Organization Active NPI

Rock and Armor Physical Therapy and Sports Performance, LLC

  • Physical Therapist
  • Meridian, ID
National Provider Identifier
1689089971
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2867 Issued in ID
Legal business name
ROCK AND ARMOR PHYSICAL THERAPY AND SPORTS PERFORMANCE, LLC
Practice address
535 N Locust Grove Rd Ste 170
Meridian, ID 83642-9020
Phone
(208) 917-2660
Fax
(208) 917-2630
NPI assigned
Jun 25, 2014
Last updated
Jun 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

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

Authorized official

Name
Timothy Williams, PTNPI 1871723064
Title
Owner/PT
Phone
(208) 917-2660

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 PT2867 ID Primary

Addresses

Primary practice location

535 N Locust Grove Rd Ste 170
Meridian, ID 83642-9020

Mailing address

535 N Locust Grove Rd Ste 170
Meridian, ID 83642-9020
Phone (208) 917-2660

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140924001090 ID Part B Supplier - Clinic/Group Practice 9931328994 Receives reassigned benefits from 21 practitioners
Practice locations: Nampa, ID; Meridian, ID; Boise, ID; Garden City, ID

National Provider Directory

National Provider Directory

Locations

2202 S Broadway Ave
Boise, ID 83706
Phone (208) 741-3911

104 W 53rd St
Garden City, ID 83714
Phone (208) 375-5511

1649 E Pine Ave
Meridian, ID 83642
Phone (208) 917-2660

535 N Locust Grove Rd
Ste 170
Meridian, ID 83642
Phone (208) 917-2660

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1689089971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 N LOCUST GROVE RD STE 170",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429020",
            "telephone_number": "208-917-2660",
            "fax_number": "208-917-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 N LOCUST GROVE RD STE 170",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429020",
            "telephone_number": "208-917-2660",
            "fax_number": "208-917-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK AND ARMOR PHYSICAL THERAPY AND SPORTS PERFORMANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-25",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER/PT",
        "authorized_official_telephone_number": "208-917-2660",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT2867",
            "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 Jun 25, 2014; 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.