Active NPI
Rilee Glenn, DPT
- Physical Therapist
- Driggs, ID
National Provider Identifier
1699145276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4067
- Practice address
- 180 S Main St Ste C2
Driggs, ID 83422-5034 - Phone
- (208) 354-3128
- NPI assigned
- Sep 25, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4067 | ID | Primary |
Addresses
Primary practice location
180 S Main St Ste C2
Driggs, ID 83422-5034
Mailing address
180 S Main St Ste C2
Driggs, ID 83422-5034
Phone (208) 354-3128
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170928001527 | ID | Practitioner - Physical Therapist in Private Practice | 6406120583 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- High Peaks Physical Therapy P a
Practice addresses (Care Compare)
180 S Main St
Suite C2
Driggs, ID 83422-5034
Phone (208) 354-3128
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4067 | ID | MD | Physical Therapist |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688515200000",
"number": "1699145276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 S MAIN ST STE C2",
"city": "DRIGGS",
"state": "ID",
"postal_code": "834225034",
"telephone_number": "208-354-3128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 S MAIN ST STE C2",
"city": "DRIGGS",
"state": "ID",
"postal_code": "834225034",
"telephone_number": "208-354-3128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENN",
"first_name": "RILEE",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-25",
"last_updated": "2023-07-05",
"certification_date": "2023-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "4067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Driggs, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.