Active NPI
Nathaniel Scott Thoreson, PT
- Specialist
- Post Falls, ID
National Provider Identifier
1790865228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- PT1354
- Practice address
- 1132 E Polston Ave
Post Falls, ID 83854-6045 - Phone
- (208) 777-7800
- Fax
- (208) 777-9209
- NPI assigned
- Oct 17, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | PT1354 | ID | Primary |
Addresses
Primary practice location
1132 E Polston Ave
Post Falls, ID 83854-6045
Mailing address
1132 E Polston Ave
Post Falls, ID 83854-6045
Phone (208) 777-7800
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010025022 | Other | ID | REGENCE BLUE SHIELD |
| T3548 | Other | ID | BLUE CROSS |
| 126619 | Other | WA | WASHINGTON L&I |
| P00155553 | Other | ID | RAILROAD MEDICARE |
| 14490 | Other | ID | GROUP HEALTH |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT1354 | ID | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790865228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1132 E POLSTON AVE",
"city": "POST FALLS",
"state": "ID",
"postal_code": "838546045",
"telephone_number": "208-777-7800",
"fax_number": "208-777-9209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1132 E POLSTON AVE",
"city": "POST FALLS",
"state": "ID",
"postal_code": "838546045",
"telephone_number": "208-777-7800",
"fax_number": "208-777-9209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORESON",
"first_name": "NATHANIEL",
"middle_name": "SCOTT",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "ID",
"license": "PT1354",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "000010025022",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "T3548",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON L&I",
"identifier": "126619",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00155553",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH",
"identifier": "14490",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Post Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.