Individual provider Active NPI

Riley Alen Grube, DPT, PT

  • Physical Therapist
  • Idaho Falls, ID
National Provider Identifier
1972337426
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8261274 Issued in ID
Practice address
2194 Snake River Pkwy
Idaho Falls, ID 83402-4346
Phone
(208) 973-4144
Fax
(208) 914-6563
NPI assigned
Aug 28, 2024
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 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 8261274 ID Primary

Addresses

Primary practice location

2194 Snake River Pkwy
Idaho Falls, ID 83402-4346

Mailing address

1411 Falls Ave E Ste 401
Twin Falls, ID 83301-3455
Phone (208) 973-4144

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241022002996 ID Practitioner - Physical Therapist in Private Practice 2163954629 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Land Rehabilitation LLCGroup PAC ID 9234048745, 207 clinicians

Practice addresses (Care Compare)

3345 Potomac Way
Idaho Falls, ID 83404-4978
Phone (208) 417-0090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8261274IDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
McDonald Rehab, PC Physical Therapist CurrentSince Sep 18, 2024 Accepting new patients
Mountain Land Rehabilitation LLC Physical Therapist CurrentSince Apr 1, 2025 Accepting new patients
Wright Physical Therapy Limited Partnership Physical Therapist PastSince Sep 1, 2024 Accepting new patients
Wright Physical Therapy Limited Partnership Physical Therapist PastSince Sep 1, 2024 Accepting new patients

Locations

1680 E 1st St
Idaho Falls, ID 83401
Phone (208) 417-0090

3345 Potomac Way
Idaho Falls, ID 83404
Phone (208) 417-0090

1800 Flandro Dr
Ste 190
Pocatello, ID 83202
Phone (208) 233-2248

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, 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": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1972337426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 FALLS AVE E STE 401",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013455",
            "telephone_number": "208-973-4144",
            "fax_number": "208-914-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2194 SNAKE RIVER PKWY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834024346",
            "telephone_number": "208-973-4144",
            "fax_number": "208-914-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBE",
        "first_name": "RILEY",
        "middle_name": "ALEN",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "8261274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 28, 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.