Active NPI
Eric Andreasen, MPT
- Physical Therapist
- Rexburg, ID
National Provider Identifier
1841563335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-1527
- Practice address
- 393 East Second North
Rexburg, ID 83440 - Phone
- (208) 359-9570
- NPI assigned
- Feb 15, 2012
- Last updated
- Feb 15, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-1527 | ID | Primary |
Addresses
Primary practice location
393 East Second North
Rexburg, ID 83440
Mailing address
475 City Street
PO Box 173
Newdale, ID 83436
Phone (208) 458-4721
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 |
|---|---|---|---|
| PT-1527 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329264000000",
"number": "1841563335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 CITY STREET",
"address_2": "PO BOX 173",
"city": "NEWDALE",
"state": "ID",
"postal_code": "83436",
"telephone_number": "208-458-4721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "393 EAST SECOND NORTH",
"city": "REXBURG",
"state": "ID",
"postal_code": "83440",
"telephone_number": "208-359-9570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDREASEN",
"first_name": "ERIC",
"credential": "MPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-15",
"last_updated": "2012-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-1527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rexburg, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.