NPIMap

Organization Active NPI

Gem Rehabilitation Services, Inc.

Doing business as Payette River Physical Therapy

  • Physical Therapist
  • Horseshoe Bend, ID
National Provider Identifier
1730219361
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
GEM REHABILITATION SERVICES, INC.
Doing business as
Payette River Physical Therapy
Practice address
400 Highway 55 Ste a
Suite B
Horseshoe Bend, ID 83629-9016
Phone
(208) 793-3333
Fax
(208) 793-6333
NPI assigned
Mar 6, 2007
Last updated
Jun 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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

Authorized official

Name
Mr. Gayle Fry
Title
Office Manager
Phone
(208) 793-3333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

400 Highway 55 Ste a
Suite B
Horseshoe Bend, ID 83629-9016

Mailing address

PO Box 205
Horseshoe Bend, ID 83629-0205
Phone (208) 793-3333

Other identifiers 5

IdentifierTypeStateIssuer
8B305OtherIDBLUE CROSS OF IDAHO GROUP
185456700OtherIDUS DEPT OF LABOR
002636700MedicaidID
000010007267OtherIDBLUE SHIELD OF IDAHO GROU
124160OtherIDWASH. STATE DEPT OF LABOR

Other names 1

  • Payette River Physical Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

101 Locust St
Ste B
Horseshoe Bend, ID 83629
Phone (208) 793-3333

400 Highway 55
Ste A
Horseshoe Bend, ID 83629
Phone (208) 793-3333

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370822400000",
    "number": "1730219361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 205",
            "city": "HORSESHOE BEND",
            "state": "ID",
            "postal_code": "836290205",
            "telephone_number": "208-793-3333",
            "fax_number": "208-621-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HIGHWAY 55 STE A",
            "address_2": "SUITE B",
            "city": "HORSESHOE BEND",
            "state": "ID",
            "postal_code": "836299016",
            "telephone_number": "208-793-3333",
            "fax_number": "208-793-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEM REHABILITATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2013-06-10",
        "status": "A",
        "authorized_official_last_name": "FRY",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-793-3333",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO GROUP",
            "identifier": "8B305",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "185456700",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002636700",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO GROU",
            "identifier": "000010007267",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASH. STATE DEPT OF LABOR",
            "identifier": "124160",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Payette River Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Horseshoe Bend, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.