NPIMap

Organization Active NPI

Center for Orthopedic Rehabilitation

  • Physical Therapist
  • Pocatello, ID
National Provider Identifier
1801944400
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-1730 Issued in ID
Legal business name
CENTER FOR ORTHOPEDIC REHABILITATION
Practice address
275 S 5TH Ave Ste 140
Pocatello, ID 83201-6410
Phone
(208) 232-4267
Fax
(208) 232-4268
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

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

Authorized official

Name
John T Bates, MPT
Title
President
Phone
(208) 232-4267

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT-1730 ID Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT-2487 ID

Addresses

Primary practice location

275 S 5TH Ave Ste 140
Pocatello, ID 83201-6410

Mailing address

275 S 5TH Ave Ste 140
Pocatello, ID 83201-6410
Phone (208) 232-4267

Other identifiers 1

IdentifierTypeStateIssuer
806506300MedicaidID

National Provider Directory

National Provider Directory

Locations

275 S 5th Ave
Ste 140
Pocatello, ID 83201
Phone (208) 232-4267

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260316800000",
    "number": "1801944400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 S 5TH AVE STE 140",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016410",
            "telephone_number": "208-232-4267",
            "fax_number": "208-232-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 S 5TH AVE STE 140",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016410",
            "telephone_number": "208-232-4267",
            "fax_number": "208-232-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR ORTHOPEDIC REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2009-12-09",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-232-4267",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-1730",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-2487",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806506300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; 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.