NPIMap

Organization Active NPI

Family Physical Therapy & Sports Medicine Clinic

  • Physical Therapist
  • Twin Falls, ID
National Provider Identifier
1699973826
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
RPT357 Issued in ID
Legal business name
FAMILY PHYSICAL THERAPY & SPORTS MEDICINE CLINIC
Practice address
834 Falls Ave Ste 1250
Twin Falls, ID 83301-3364
Phone
(208) 733-3900
Fax
(208) 733-3908
NPI assigned
Jul 10, 2007
Last updated
Jul 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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

Authorized official

Name
David B Little, P.T.NPI 1174642961
Title
Owner / Physical Therapist
Phone
(208) 733-3900

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 Therapist 225100000X RPT357 ID Primary

Addresses

Primary practice location

834 Falls Ave Ste 1250
Twin Falls, ID 83301-3364

Mailing address

834 Falls Ave Ste 1250
Twin Falls, ID 83301-3364
Phone (208) 733-3900

Other identifiers 3

IdentifierTypeStateIssuer
T9115OtherIDBLUE CROSS OF IDAHO
1375725OtherIDMEDICARE GROUP
000010026870OtherIDREGNECE BLUE SHIELD OF ID

National Provider Directory

National Provider Directory

Locations

834 Falls Ave
Ste 1250
Twin Falls, ID 83301
Phone (208) 733-3900

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": "1184025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184025600000",
    "number": "1699973826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "834 FALLS AVE STE 1250",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013364",
            "telephone_number": "208-733-3900",
            "fax_number": "208-733-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 FALLS AVE STE 1250",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013364",
            "telephone_number": "208-733-3900",
            "fax_number": "208-733-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PHYSICAL THERAPY & SPORTS MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER / PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "208-733-3900",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "RPT357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "T9115",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "1375725",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGNECE BLUE SHIELD OF ID",
            "identifier": "000010026870",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; 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.