Individual provider Active NPI

Kevin Helgeson, PT

  • Physical Therapist
  • Pocatello, ID
National Provider Identifier
1700090537
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1894 Issued in ID
Practice address
8045 Isu Campus Stop
Pocatello, ID 83209-0001
Phone
(208) 282-4095
Fax
(208) 282-4962
NPI assigned
May 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1894 ID Primary

Addresses

Primary practice location

8045 Isu Campus Stop
Pocatello, ID 83209-0001

Mailing address

799 Green Dr
Pocatello, ID 83204-4684
Phone (208) 233-4955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1894IDMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700090537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 GREEN DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832044684",
            "telephone_number": "208-233-4955",
            "fax_number": "208-282-4962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8045 ISU CAMPUS STOP",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832090001",
            "telephone_number": "208-282-4095",
            "fax_number": "208-282-4962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELGESON",
        "first_name": "KEVIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "1894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.