Active NPI
Daniel Nathan Hernandez, PT, DPT, SCS
- Sports Physical Therapist
- Mountain Home Afb, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physical Therapist
- License
- 1571196
- Practice address
- 725 Alpine St BLDG 210
Mountain Home Afb, ID 83648-5405 - Phone
- (254) 699-3933
- NPI assigned
- Feb 10, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Sports Physical Therapist | 2251S0007X | 1571196 | ID | Primary |
Addresses
Primary practice location
725 Alpine St BLDG 210
Mountain Home Afb, ID 83648-5405
Mailing address
133 Magnolia Ave SE
Fort Walton Beach, FL 32548-7266
Phone (850) 739-4936
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1571196 | ID | MD | Sports Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia Physical Therapy Inc PS | Sports | Current | Accepting new patients |
Locations
214 Ash St
Grandview, WA 98930
Phone (509) 203-0959
7201 W Clearwater Ave
Ste B101
Kennewick, WA 99336
Phone (509) 544-0265
35 S Louisiana St
Ste A140
Kennewick, WA 99336
Phone (509) 582-0429
343 Wellsian Way
Richland, WA 99352
Phone (509) 547-3673
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769644800000",
"number": "1750973616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 MAGNOLIA AVE SE",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325487266",
"telephone_number": "850-739-4936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 ALPINE ST BLDG 210",
"city": "MOUNTAIN HOME AFB",
"state": "ID",
"postal_code": "836485405",
"telephone_number": "254-699-3933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "DANIEL",
"middle_name": "NATHAN",
"credential": "PT, DPT, SCS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-10",
"last_updated": "2026-01-29",
"certification_date": "2026-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "2251S0007X",
"taxonomy_group": "",
"desc": "Physical Therapist, Sports",
"state": "ID",
"license": "1571196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mountain Home Afb, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; 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.