Individual provider Active NPI

Christine F Waite, DPT

  • Physical Therapist
  • Pocatello, ID
National Provider Identifier
1952733552
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 3222 Issued in ID
Practice address
1400 E Terry Dr Buliding 63 Floor 2
Pocatello, ID 83209-6408
Phone
(208) 282-2590
Fax
(833) 499-1813
NPI assigned
Aug 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 3222 ID Primary

Addresses

Primary practice location

1400 E Terry Dr Buliding 63 Floor 2
Pocatello, ID 83209-6408

Mailing address

1400 E Terry Dr Buliding 63 Floor 2
Pocatello, ID 83209-6408
Phone (208) 282-2590

Other names 1

  • Christine Frances Fischer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130924000530 ID Practitioner - Physical Therapist in Private Practice 0446494942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Idaho State UniversityGroup PAC ID 4688683030, 19 clinicians

Practice addresses (Care Compare)

1400 E Terry Dr BLDG
Suite 63
Pocatello, ID 83209-9984
Phone (208) 282-2590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 3222IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho State University CurrentSince Sep 1, 2024 Accepting new patients
Idaho State University CurrentSince Sep 1, 2024 Accepting new patients
Idaho State University Current Accepting new patients
Idaho State University Physical Therapist Past Accepting new patients

Locations

1311 E Central Dr
Meridian, ID 83642
Phone (208) 373-1734

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1952733552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E TERRY DR BULIDING 63 FLOOR 2",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832096408",
            "telephone_number": "208-282-2590",
            "fax_number": "833-499-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E TERRY DR BULIDING 63 FLOOR 2",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832096408",
            "telephone_number": "208-282-2590",
            "fax_number": "833-499-1813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITE",
        "first_name": "CHRISTINE",
        "middle_name": "F",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-06",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT 3222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "FISCHER",
            "middle_name": "FRANCES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.