Active NPI
Therady LLC
- Physical Therapist
- Ammon, ID
National Provider Identifier
1902754203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- THERADY LLC
- Practice address
- 1489 Midway Ave
Ammon, ID 83406 - Phone
- (208) 904-3311
- NPI assigned
- Mar 20, 2026
- Last updated
- Jul 30, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Vanorden
- Title
- President
- Phone
- (208) 904-3311
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | |||
| Physical Therapist | 225100000X | Primary | ||
| Physical Therapy Assistant | 225200000X | |||
| Occupational Therapist | 225X00000X | |||
| Speech-Language Pathologist | 235Z00000X |
Addresses
Primary practice location
1489 Midway Ave
Ammon, ID 83406
Mailing address
PO Box 235
Pocatello, ID 83204-0235
Phone (208) 904-3311
Other practice location 1
1489 Center Park Dr
Ammon, ID 83406
Phone (208) 904-3311
National Provider Directory
National Provider DirectoryLocations
1489 Midway Ave
Ammon, ID 83406
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773964800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1785369600000",
"number": "1902754203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 235",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832040235",
"telephone_number": "208-904-3311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1489 MIDWAY AVE",
"city": "AMMON",
"state": "ID",
"postal_code": "83406",
"telephone_number": "208-904-3311"
}
],
"practiceLocations": [
{
"address_1": "1489 Center Park Dr",
"address_purpose": "LOCATION",
"city": "Ammon",
"state": "ID",
"postal_code": "83406",
"country_code": "US",
"telephone_number": "208-904-3311",
"fax_number": "208-247-5815",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "THERADY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-03-20",
"last_updated": "2026-07-30",
"certification_date": "2026-07-30",
"status": "A",
"authorized_official_last_name": "VANORDEN",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "208-904-3311"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ammon, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.