Active NPI
Annette Renee Hill, M.P.T.
- Physical Therapist
- Idaho Falls, ID
National Provider Identifier
1912639618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2132
- Practice address
- 720 S Woodruff Ave
Idaho Falls, ID 83401-5285 - Phone
- (208) 552-5025
- NPI assigned
- Jun 30, 2022
- Last updated
- Jun 30, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 2132 | ID | Primary |
Addresses
Primary practice location
720 S Woodruff Ave
Idaho Falls, ID 83401-5285
Mailing address
720 S Woodruff Ave
Idaho Falls, ID 83401-5285
Phone (208) 552-5025
Other names 1
- Annette Renee McCubbin
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 |
|---|---|---|---|
| 2132 | ID | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabauthority, LLC | Physical Therapist | Current | Accepting new patients |
Locations
720 S Woodruff Ave
Idaho Falls, ID 83401
Phone (208) 322-8709
2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656547200000",
"number": "1912639618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "720 S WOODRUFF AVE",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834015285",
"telephone_number": "208-552-5025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 S WOODRUFF AVE",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834015285",
"telephone_number": "208-552-5025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILL",
"first_name": "ANNETTE",
"middle_name": "RENEE",
"credential": "M.P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-30",
"last_updated": "2022-06-30",
"certification_date": "2022-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "2132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANNETTE",
"last_name": "MCCUBBIN",
"middle_name": "RENEE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.