NPIMap

Organization Active NPI

Pick PT

  • Physical Therapist
  • Rexburg, ID
National Provider Identifier
1861977480
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PICK PT
Practice address
526 First American Cir Ste B
Rexburg, ID 83440-5400
Phone
(208) 534-7001
Fax
(208) 534-7002
NPI assigned
Sep 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Authorized official

Name
Cordell Pickering, DPTNPI 1124514286
Title
DPT, Co-Owner
Phone
(208) 881-3616

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

526 First American Cir Ste B
Rexburg, ID 83440-5400

Mailing address

1940 S Bonito Way Ste 190
Meridian, ID 83642-5618
Phone (208) 287-9420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190124001856 ID Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5496092702 Receives reassigned benefits from 6 practitioners
Practice locations: Rexburg, ID

National Provider Directory

National Provider Directory

Locations

2277 E Lincoln Rd
Idaho Falls, ID 83401
Phone (208) 534-7001

526 First American Cir
#B
Rexburg, ID 83440
Phone (208) 534-7001

160 W 2nd S
Ste 1
Rexburg, ID 83440
Phone (208) 534-7001

Practitioners & affiliated clinicians

Practitioners 9

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": "1538092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1861977480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 S BONITO WAY STE 190",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425618",
            "telephone_number": "208-287-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 FIRST AMERICAN CIR STE B",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405400",
            "telephone_number": "208-534-7001",
            "fax_number": "208-534-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICK PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-28",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "PICKERING",
        "authorized_official_first_name": "CORDELL",
        "authorized_official_title_or_position": "DPT, CO-OWNER",
        "authorized_official_telephone_number": "208-881-3616",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 Mar 1, 2023; 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.