Individual provider Active NPI

Joseph Monte Wight, DPT

  • Orthopedic Physical Therapist
  • Idaho Falls, ID
National Provider Identifier
1851645634
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT-2856 Issued in ID
Practice address
2037 E 17TH St
Idaho Falls, ID 83404-6430
Phone
(208) 529-3355
Fax
(208) 529-9581
NPI assigned
Nov 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT-2856 ID Primary

Addresses

Primary practice location

2037 E 17TH St
Idaho Falls, ID 83404-6430

Mailing address

2037 E 17TH St
Idaho Falls, ID 83404-6430
Phone (208) 529-3355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190128002233 ID Practitioner - Physical Therapist in Private Practice 1759628845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wight Chiropractic PAGroup PAC ID 1052321429, 3 clinicians

Practice addresses (Care Compare)

333 S Woodruff Ave
Idaho Falls, ID 83401-4322
Phone (208) 522-2591

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-2856IDMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wight Chiropractic, PA CurrentSince Oct 1, 2018 Accepting new patients
Teton Physical Therapy, Inc Orthopedic PastSince Jul 1, 2000 Accepting new patients

Locations

333 S Woodruff Ave
Idaho Falls, ID 83401
Phone (208) 522-2591

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1851645634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2037 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046430",
            "telephone_number": "208-529-3355",
            "fax_number": "208-529-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2037 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046430",
            "telephone_number": "208-529-3355",
            "fax_number": "208-529-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGHT",
        "first_name": "JOSEPH",
        "middle_name": "MONTE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-01",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "ID",
            "license": "PT-2856",
            "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 Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.