NPIMap

Organization Active NPI

Coeur D'Alene Tribe Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Plummer, ID
National Provider Identifier
1730104225
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
COEUR D'ALENE TRIBE PHYSICAL THERAPY, LLC
Practice address
110 A Street
Plummer, ID 83851
Phone
(208) 686-1931
Fax
(208) 686-9061
NPI assigned
Jul 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. John E. Rowland
Title
Manager Patient Financial Services
Phone
(208) 686-1931

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

110 A Street
Plummer, ID 83851

Mailing address

PO Box 516
Plummer, ID 83851
Phone (208) 686-1931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070807000468 ID Part B Supplier - Clinic/Group Practice 9133210024 Receives reassigned benefits from 2 practitioners
Practice locations: Plummer, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730104225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 516",
            "city": "PLUMMER",
            "state": "ID",
            "postal_code": "83851",
            "telephone_number": "208-686-1931",
            "fax_number": "208-686-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 A STREET",
            "city": "PLUMMER",
            "state": "ID",
            "postal_code": "83851",
            "telephone_number": "208-686-1931",
            "fax_number": "208-686-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COEUR D'ALENE TRIBE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROWLAND",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "MANAGER PATIENT FINANCIAL SERVICES",
        "authorized_official_telephone_number": "208-686-1931",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plummer, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.