Rebound Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

REBOUND PHYSICAL THERAPY PC

Practice address

1175 E Parkcenter Blvd
Ste 104
Boise, ID 83706-6751

Phone

(208) 344-2525

Fax

(208) 344-3056

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Randall K Langley, RPT, OCSNPI 1598852139

Title

Owner

Phone

(208) 939-3332

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda J Dunne, PT

  • Physical Therapist
  • Boise, ID
  • NPI 1104040237
  Medicare reassignment Care Compare group NPD
• Randall Keith Langley, RPT, OCS

  • Physical Therapist
  • Eagle, ID
  • NPI 1598852139
  Medicare reassignment NPD Authorized official
• Caleb Louvier, PT

  • Physical Therapist
  • Boise, ID
  • NPI 1841545696
  Medicare reassignment Care Compare group NPD
• Anthony Todd Peppley, PT

  • Physical Therapist
  • Eagle, ID
  • NPI 1144335860
  Medicare reassignment Care Compare group NPD
• Ian David Tracy, DPT

  • Physical Therapist
  • Boise, ID
  • NPI 1134643885
  Medicare reassignment NPD

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273104000000",
    "number": "1891882486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 E PARKCENTER BLVD",
            "address_2": "STE 104",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837066751",
            "telephone_number": "208-344-2525",
            "fax_number": "208-344-3056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 E PARKCENTER BLVD",
            "address_2": "STE 104",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837066751",
            "telephone_number": "208-344-2525",
            "fax_number": "208-344-3056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBOUND PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-05-06",
        "status": "A",
        "authorized_official_last_name": "LANGLEY",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-939-3332",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPT, OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "T9401",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807277100",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010151218",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; 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.