Active NPI
Garrett Weldon, DPT
- Physical Therapist
- Meridian, ID
National Provider Identifier
1912319740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-3629
- Practice address
- 3551 E Overland Rd
Meridian, ID 83642-6757 - Phone
- (208) 888-3900
- Fax
- (208) 888-6767
- NPI assigned
- May 28, 2014
- Last updated
- May 28, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-3629 | ID | Primary |
Addresses
Primary practice location
3551 E Overland Rd
Meridian, ID 83642-6757
Mailing address
1560 S Carol St
Meridian, ID 83646-1839
Phone (208) 288-1155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-3629 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1401235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401235200000",
"number": "1912319740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1560 S CAROL ST",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836461839",
"telephone_number": "208-288-1155",
"fax_number": "208-288-0424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 E OVERLAND RD",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836426757",
"telephone_number": "208-888-3900",
"fax_number": "208-888-6767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELDON",
"first_name": "GARRETT",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-28",
"last_updated": "2014-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-3629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.