NPIMap

Organization Active NPI

Foothills Rehabilitation & Performance Services

  • Physical Therapy Clinic/Center
  • Idaho Falls, ID
National Provider Identifier
1831211093
Registry record updated Jun 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FOOTHILLS REHABILITATION & PERFORMANCE SERVICES
Practice address
3814 Washington Pkwy
Idaho Falls, ID 83404-7591
Phone
(208) 529-3562
Fax
(208) 529-4064
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2008

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

Authorized official

Name
Brent Sheldon Kennedy, DPTNPI 1295855112
Title
Owner
Phone
(208) 529-3562

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X ID Primary

Addresses

Primary practice location

3814 Washington Pkwy
Idaho Falls, ID 83404-7591

Mailing address

3814 Washington Pkwy
Idaho Falls, ID 83404-7591
Phone (208) 529-3562

National Provider Directory

National Provider Directory
Tax ID family
Foothills Rehabilitation Performance Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3814 Washington Pkwy
Idaho Falls, ID 83404
Phone (208) 360-4584

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": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1831211093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047591",
            "telephone_number": "208-529-3562",
            "fax_number": "208-529-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3814 WASHINGTON PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047591",
            "telephone_number": "208-529-3562",
            "fax_number": "208-529-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS REHABILITATION & PERFORMANCE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "SHELDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-529-3562",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.