Jason Ray Hyde, MPT
Individual provider Active NPI Physical Therapist · Blackfoot, ID
NPI 1700102662 · NPPES record last updated Mar 21, 2013
Key facts
- NPI
- 1700102662
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT-1987 (ID)
- Practice address
- 725 Jensen Grove Dr
Suite 4
Blackfoot, ID 83221-1636 - Phone
- (208) 227-6255
- NPI assigned
- Apr 15, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hyde Physical Therapy | Physical Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-1987 | ID | Yes |
Addresses
Primary practice location
725 Jensen Grove Dr
Suite 4
Blackfoot, ID 83221-1636
Mailing address
PO Box 730
Blackfoot, ID 83221-0730
Phone (208) 227-6255
Other providers in Blackfoot, ID
- Samantha Hrabik
- Steven Wayne Hulse
- Ryan B Hurst
- Hyde Physical Therapy
- Hyde Physical Therapy
- Tresa Hyde
- Idaho Dept of Health & Welfare Reg 6 CMH BF C
- Idaho Dept of Health & Welfare Reg 7 Amh BF
- Idaho Dept of Health & Welfare Reg 7 CMH P C
- Idaho Express Transportation LLC
All providers in Blackfoot, ID · Physical Therapist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.