Individual provider Active NPI

Rilee Glenn, DPT

  • Physical Therapist
  • Driggs, ID
National Provider Identifier
1699145276
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4067 Issued in ID
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

Updated by the provider on Jul 5, 2023

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 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 IDStateProvider typePAC IDDetails
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 8 clinicians

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

LicenseStateTypeSpecialty
4067IDMDPhysical 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.

Verify at the official NPI Registry.