Camp Hippo Pediatric Therapy LLC.
Organization Active NPI Multi-Specialty Clinic/Center · Blackfoot, ID
NPI 1902084833 · NPPES record last updated Feb 1, 2008
Key facts
- NPI
- 1902084833
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- License
- OT-232 (ID)
- Legal business name
- CAMP HIPPO PEDIATRIC THERAPY LLC.
- Practice address
- 7 N 600 W
Blackfoot, ID 83221-5533 - Phone
- (208) 782-2267
- Fax
- (208) 684-9812
- NPI assigned
- Feb 1, 2008
- Organization subpart
- No
Authorized official
- Name
- Mrs. Betty C. Jaques, OTR/L
- Title
- Occupational Therapist/Owner
- Phone
- (208) 782-2267
Corporate family (same tax ID) 1
Practitioners 12
-
Betty Christina Jaques, OTRL
-
Kerry Lynn Bowman, MS, CCC-SLP
-
Margaret Frei, COTA/L
-
Amber Valene Hawker, PTA
-
Amy Hopkins, M.S., CCC-SLP
-
Emily Jeanne Lindorfer, M.S., CF-SLP
-
Amy Moser, M.S. CCC-SLP
-
Tayler Peck, COTA
-
Courtney Porter, PTA
-
Holly Maurine St. John, MOTR/L
-
Morgen Tayler Stott, MOT
-
Dale C Wheelwright, RPT
National Provider Directory
- Tax ID family
- Camp Hippo Pediatric Therapy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | OT-232 | ID | Yes |
| Medical Specialty Clinic/Center | 261QM2500X | OT-232 | ID |
Addresses
Primary practice location
7 N 600 W
Blackfoot, ID 83221-5533
Mailing address
7 N 600 W
Blackfoot, ID 83221-5533
Phone (208) 782-2267
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 232-OT | Other | ID | OT LICENSE |
Other providers in Blackfoot, ID
- Cody Allen Burgess
- Richard Russell Burt
- Gary D Call
- Thomas Call
- Camp Hippo Pediatric Therapy LLC
- Chelsee Ann Campbell
- Amador Ramirez Cantu
- Angelo Michael Capricchione
- Jean Marc Cardinal
- Katrina Haley Carl
All providers in Blackfoot, ID · Multi-Specialty Clinic/Center in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.