Lakewood Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

LAKEWOOD PHYSICAL THERAPY LLC

Practice address

1401 Lincoln Way
Coeur D Alene, ID 83814-2334

Phone

(208) 676-1424

NPI assigned

Nov 22, 2006

Last updated

Oct 16, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

NORTH IDAHO FAMILY PHYSICIANSAs reported in NPPES

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

Authorized official

Name

Eric Koelsch

Title

Executive Director

Phone

(208) 676-0145

Specialties & licenses 1

Addresses

Other identifiers 1

Part of

North Idaho Family Phys

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• North Idaho Family Physicians, LLC

  dba After Hours Urgent Care Clinic

  • Family Medicine Physician
  • Post Falls, ID
  • NPI 1669546388

  Member Of

  NPD member

Locations

Practitioners 1

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.

• Clifford Kiracofe, RPT

  • Physical Therapist
  • Hayden, ID
  • NPI 1427073212
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255651200000",
    "number": "1699840835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR",
            "address_2": "SUITE 272E",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 LINCOLN WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142334",
            "telephone_number": "208-676-1424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD PHYSICAL THERAPY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH IDAHO FAMILY PHYSICIANS",
        "enumeration_date": "2006-11-22",
        "last_updated": "2009-10-16",
        "status": "A",
        "authorized_official_last_name": "KOELSCH",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "208-676-0145"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG9013",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake City Surgeons PLLC
• Lakeside Eyecare
• Lakeside Holistic Health, PLLC
• Lakeside Pediatric & Adolescent Medicine, PLLC
• Lakeview Dental
• Jared Lambert
• Tom Lamphier
• Teresa Ann Lancaster, M.S., SLP-CCC
• Elizabeth Landers, PA-C
• James Lee Landers, DDS

• Physical Therapist in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2009; 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.