Active NPI
Chandra T Farnham, PT
- Physical Therapist
- Pocatello, ID
National Provider Identifier
1710671862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-8317
- Practice address
- 335 E Lewis St Ste 10
Pocatello, ID 83201-6408 - Phone
- (208) 269-2360
- Fax
- (208) 550-3256
- NPI assigned
- Jun 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-8317 | ID | Primary |
Addresses
Primary practice location
335 E Lewis St Ste 10
Pocatello, ID 83201-6408
Mailing address
335 E Lewis St Ste 10
Pocatello, ID 83201-6408
Phone (208) 269-2360
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-8317 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685664000000",
"number": "1710671862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "335 E LEWIS ST STE 10",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832016408",
"telephone_number": "208-269-2360",
"fax_number": "208-550-3256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 E LEWIS ST STE 10",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832016408",
"telephone_number": "208-269-2360",
"fax_number": "208-550-3256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARNHAM",
"first_name": "CHANDRA",
"middle_name": "T",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-02",
"last_updated": "2023-06-02",
"certification_date": "2023-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-8317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pocatello, ID
- Robin Pierce Falslev, M.A., CCC-SLP
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- Family Practice Group, P.a. (Intermountain Medical Clinic)
- Brent M. Faure, MS, ATC
- Caroline E Faure, ED.D.; ATC
- Wesston Ford Faux, PHARMD
- Douglas Favor, MD
- Fellows Family Dental - Ad LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.