NPIMap

Organization Active NPI

Hyde Physical Therapy

  • Physical Therapy Clinic/Center
  • Blackfoot, ID
National Provider Identifier
1700128337
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PT-1987 Issued in ID
Legal business name
HYDE PHYSICAL THERAPY
Practice address
725 Jensen Grove Dr
Suite 4
Blackfoot, ID 83221-1636
Phone
(208) 785-3462
Fax
(208) 785-3453
NPI assigned
Mar 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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

Authorized official

Name
Jason R Hyde, P.T.NPI 1700102662
Title
Physicals Therapist/Owner
Phone
(208) 227-6255

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 Therapy Clinic/Center 261QP2000X PT-1987 ID Primary

Addresses

Primary practice location

725 Jensen Grove Dr
Suite 4
Blackfoot, ID 83221-1636

Mailing address

725 Jensen Grove Dr
Suite 4
Blackfoot, ID 83221-1636
Phone (208) 785-3462

Other names 1

  • Hyde Ellis Physical Therapy Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Hyde Ellis Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379030400000",
    "number": "1700128337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 JENSEN GROVE DR",
            "address_2": "SUITE 4",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211636",
            "telephone_number": "208-785-3462",
            "fax_number": "208-785-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 JENSEN GROVE DR",
            "address_2": "SUITE 4",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211636",
            "telephone_number": "208-785-3462",
            "fax_number": "208-785-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-21",
        "last_updated": "2013-09-13",
        "status": "A",
        "authorized_official_last_name": "HYDE",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICALS THERAPIST/OWNER",
        "authorized_official_telephone_number": "208-227-6255",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "ID",
            "license": "PT-1987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hyde Ellis Physical Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Blackfoot, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.