Active NPI
Christopher J Lougheed, DPT
- Physical Therapist
- Eagle, ID
National Provider Identifier
1760627038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-3215
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760627038 | Medicaid | ID |
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.
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iti Physical Therapy & Sports Performance LLC | Physical Therapist | Current | Accepting new patients |
| Rehabauthority, LLC | Physical Therapist | Past | 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.
-
- Physical Therapist
- Knox, ME
- NPI 1396484937
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.