Chad R Simmons, DPT
Individual provider Active NPI Physical Therapist · Ririe, ID
NPI 1780163303 · NPPES record last updated Apr 3, 2023
Key facts
- NPI
- 1780163303
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT-5816 (ID)
- Practice address
- 245 Main St
Ririe, ID 83443 - Phone
- (208) 900-6336
- Fax
- (208) 900-4408
- NPI assigned
- Aug 14, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
245 Main St
Ririe, ID 83443-7713
Phone (208) 542-3961
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181109002271 | ID | Practitioner - Physical Therapist in Private Practice | 5799039707 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4100 | NV | MD | Dentist |
| PT-5816 | ID | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Physical Therapy PLLC | Physical Therapist | Current |
Accepting new patients |
| McCall Physical Therapy, P.a. | Physical Therapist | Past | Accepting new patients |
| Therapy West LLC | Physical Therapist | Past | Accepting new patients |
Locations
112 S Main St
Ste H
Firth, ID 83236
Phone (208) 900-6336
112 S Main St
Firth, ID 83236
Phone (208) 390-1793
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-5816 | ID | Yes |
Addresses
Primary practice location
245 Main St
Ririe, ID 83443
Mailing address
PO Box 273
Ririe, ID 83443-0273
Phone (208) 900-6336
Other practice location 1
112 S Main St Ste H
Firth, ID 83236-1168
Phone (208) 900-6336
Other providers in Ririe, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.