NPIMap

Organization Active NPI

Idaho Hand & Upper Extremity Therapy

  • Hand Occupational Therapist
  • Coeur d'Alene, ID
National Provider Identifier
1699087346
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
OT-705 Issued in ID
Legal business name
IDAHO HAND & UPPER EXTREMITY THERAPY
Practice address
920 W Ironwood Dr Ste 207
Coeur D Alene, ID 83814-2643
Phone
(208) 651-4551
NPI assigned
Jul 10, 2010
Last updated
Jan 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Authorized official

Name
Robert Swider, OTR/L, CHTNPI 1306851969
Title
Owner
Phone
(208) 651-4551

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
Hand Occupational Therapist 225XH1200X OT-705 ID Primary

Addresses

Primary practice location

920 W Ironwood Dr Ste 207
Coeur D Alene, ID 83814-2643

Mailing address

PO Box 3482
Post Falls, ID 83877-3482
Phone (208) 651-4551

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101004000456 ID DME Supplier - Independently-Practicing Occupational Therapist 4183816655 Practice locations: Coeur D Alene, ID
O20101209000208 ID Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4183816655 Receives reassigned benefits from 1 practitioner
Practice locations: Coeur D Alene, ID

National Provider Directory

National Provider Directory
Tax ID family
Idaho Hand Upper Extremity Therapy DME2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295827200000",
    "number": "1699087346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3482",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838773482",
            "telephone_number": "208-651-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 W IRONWOOD DR STE 207",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142643",
            "telephone_number": "208-651-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO HAND & UPPER EXTREMITY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-10",
        "last_updated": "2011-01-24",
        "status": "A",
        "authorized_official_last_name": "SWIDER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-651-4551",
        "authorized_official_credential": "OTR/L, CHT"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "ID",
            "license": "OT-705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; 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.