NPIMap

Organization Active NPI

Foothills Physical Therapy PA

  • Specialist
  • Meridian, ID
National Provider Identifier
1851457675
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
FOOTHILLS PHYSICAL THERAPY PA
Practice address
1618 Millenium Way
Suite 210
Meridian, ID 83642-6439
Phone
(208) 884-4647
NPI assigned
Dec 28, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Brooks Aberg, PT
Title
Secratary
Phone
(208) 343-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ID Primary

Addresses

Primary practice location

1618 Millenium Way
Suite 210
Meridian, ID 83642-6439

Mailing address

1673 W Shoreline Dr
Suite 230
Boise, ID 83702-6730
Phone (208) 343-4700

Other identifiers 1

IdentifierTypeStateIssuer
806761700MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050831000096 ID Part B Supplier - Clinic/Group Practice 9931010014 Receives reassigned benefits from 35 practitioners
Practice locations: Boise, ID; Eagle, ID; Meridian, ID

National Provider Directory

National Provider Directory

Locations

1673 W Shoreline Dr
Ste 230
Boise, ID 83702
Phone (208) 343-4700

599 S Americana Blvd
Boise, ID 83702
Phone (208) 343-4700

645 E State St
Ste 101
Eagle, ID 83616
Phone (208) 939-9594

1256 S Rackham Way
Ste 110
Meridian, ID 83642
Phone (208) 939-9594

1618 S Millenium Way
Ste 210
Meridian, ID 83642
Phone (208) 884-4647

904 S Vanguard Way
#110
Meridian, ID 83642
Phone (208) 803-6767

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1851457675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1673 W SHORELINE DR",
            "address_2": "SUITE 230",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026730",
            "telephone_number": "208-343-4700",
            "fax_number": "208-343-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 MILLENIUM WAY",
            "address_2": "SUITE 210",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426439",
            "telephone_number": "208-884-4647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS PHYSICAL THERAPY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ABERG",
        "authorized_official_first_name": "BROOKS",
        "authorized_official_title_or_position": "SECRATARY",
        "authorized_official_telephone_number": "208-343-4700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806761700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.