Individual provider Active NPI

Christopher J Lougheed, DPT

  • Physical Therapist
  • Eagle, ID
National Provider Identifier
1760627038
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-3215 Issued in ID
Practice address
77 N Fisher Park Way
Eagle, ID 83616-4796
Phone
(208) 972-0918
Fax
(877) 890-5617
NPI assigned
Dec 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-3215 ID Primary
Rehabilitation Practitioner 225400000X

Addresses

Primary practice location

77 N Fisher Park Way
Eagle, ID 83616-4796

Mailing address

2965 E Tarpon Dr Ste 150
Meridian, ID 83642-9007
Phone (208) 287-9420

Other practice location 1

1255 N Allen Ave
Fruitland, ID 83619-2208
Phone (208) 972-0918

Other identifiers 1

IdentifierTypeStateIssuer
1760627038MedicaidID

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Iti Physical Therapy & Sports Performance LLC Physical Therapist Current Accepting new patients
Rehabauthority, LLC Physical Therapist PastSince Feb 4, 2015 Accepting new patients

Organizations & group practices 2

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": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1760627038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 E TARPON DR STE 150",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836429007",
            "telephone_number": "208-287-9420",
            "fax_number": "208-287-9426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 N FISHER PARK WAY",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836164796",
            "telephone_number": "208-972-0918",
            "fax_number": "877-890-5617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 N Allen Ave",
            "address_purpose": "LOCATION",
            "city": "Fruitland",
            "state": "ID",
            "postal_code": "836192208",
            "country_code": "US",
            "telephone_number": "208-972-0918",
            "fax_number": "877-890-5617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOUGHEED",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-3215",
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760627038",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.