Individual provider Active NPI

Gary Douglas Schneider, P.T.

  • Physical Therapist
  • Hayden, ID
National Provider Identifier
1750321071
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 702 Issued in ID
Practice address
8257 N Cornerstone Dr
Hayden, ID 83835-8683
Phone
(208) 772-0881
Fax
(208) 762-2625
NPI assigned
Jun 7, 2006
Last updated
Aug 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 702 ID Primary

Addresses

Primary practice location

8257 N Cornerstone Dr
Hayden, ID 83835-8683

Mailing address

PO Box 3115
Hayden, ID 83835-3115
Phone (208) 772-8147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070108000385 ID Practitioner - Physical Therapist in Private Practice 0143123752 Reassigns benefits to 1 organization
I20070828000563 WA Practitioner - Physical Therapist in Private Practice 0143123752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alpine Physical Therapy Center, P.C.Group PAC ID 9436159969, 3 clinicians

Practice addresses (Care Compare)

328 W 4TH St
Newport, WA 99156-9094
Phone (509) 671-3122

8257 N Cornerstone Dr
Hayden, ID 83835-8683
Phone (208) 762-0881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 702IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy Center of Post Physical Therapist CurrentSince Nov 30, 2001 Accepting new patients
Alpine Physical Therapy Center, P.C. Physical Therapist CurrentSince Jul 1, 2009 Accepting new patients
Lakeside Physical Therapy LLC Physical Therapist PastSince Jan 1, 2000 Accepting new patients
CG Physical Therapy Services Inc Past Accepting new patients

Locations

8257 N Cornerstone Dr
Hayden, ID 83835
Phone (208) 762-0881

185 W 4th Ave
Ste C
Post Falls, ID 83854
Phone (208) 457-8746

328 W 4th St
Newport, WA 99156
Phone (509) 240-4856

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1750321071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3115",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838353115",
            "telephone_number": "208-772-8147",
            "fax_number": "208-762-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8257 N CORNERSTONE DR",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358683",
            "telephone_number": "208-772-0881",
            "fax_number": "208-762-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "GARY",
        "middle_name": "DOUGLAS",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT 702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayden, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.