Active NPI
Nancy J Bryant, P.T.
- Physical Therapist
- Salmon, ID
National Provider Identifier
1720085046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- RPT-092
- Practice address
- 802 Shoup St
Salmon, ID 83467-4305 - Phone
- (208) 756-2005
- Fax
- (208) 756-4020
- NPI assigned
- Jul 1, 2005
- Reactivated
- Apr 3, 2006
- Last updated
- Jan 13, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | RPT-092 | ID | Primary |
Addresses
Primary practice location
802 Shoup St
Salmon, ID 83467-4305
Mailing address
PO Box 1170
Salmon, ID 83467-1170
Phone (208) 756-2005
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T0304 | Other | ID | BLUE CROSS |
| 1650588 | Other | ID | OTHER MISC. INSURANCES |
| 820517063 | Other | ID | CHAMPUS |
| 000010018448 | Other | ID | REGENCE BLUE SHIELD |
| 002721200 | Medicaid | ID | |
| 185549800 | Other | ID | US DEPT OF LABOR |
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 |
|---|---|---|---|
| RPT-092 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263340800000",
"number": "1720085046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1170",
"city": "SALMON",
"state": "ID",
"postal_code": "834671170",
"telephone_number": "208-756-2005",
"fax_number": "208-756-4020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 SHOUP ST",
"city": "SALMON",
"state": "ID",
"postal_code": "834674305",
"telephone_number": "208-756-2005",
"fax_number": "208-756-4020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYANT",
"first_name": "NANCY",
"middle_name": "J",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-01",
"last_updated": "2010-01-13",
"deactivation_date": "2006-03-20",
"reactivation_date": "2006-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "RPT-092",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "T0304",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER MISC. INSURANCES",
"identifier": "1650588",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "820517063",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "000010018448",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002721200",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPT OF LABOR",
"identifier": "185549800",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salmon, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.