NPIMap

Organization Active NPI

Spine and Sport Pysical Therapy PC

  • Physical Therapist
  • Rexburg, ID
National Provider Identifier
1992975825
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1346 Issued in ID
Legal business name
SPINE AND SPORT PYSICAL THERAPY PC
Practice address
217 N 2ND East
Rexburg, ID 83440-1621
Phone
(208) 359-6127
Fax
(208) 359-9479
NPI assigned
Mar 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Authorized official

Name
Jody Boyd Rawlings, P.T.NPI 1497897458
Title
Physical Therapist
Phone
(208) 359-6127

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 1346 ID Primary

Addresses

Primary practice location

217 N 2ND East
Rexburg, ID 83440-1621

Mailing address

217 N 2ND East
Rexburg, ID 83440-2057
Phone (208) 359-6127

Other identifiers 5

IdentifierTypeStateIssuer
805399800MedicaidID
000010020600OtherIDREGENCE BLUE SHIELD
185556100OtherUS DEPARTMENT OF LABOR
T3860OtherIDBLUE CROSS
650015362OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040427000396 ID Part B Supplier - Clinic/Group Practice 5799772380 Receives reassigned benefits from 4 practitioners
Practice locations: Rexburg, ID

National Provider Directory

National Provider Directory

Locations

217 N 2nd E
Rexburg, ID 83440
Phone (208) 359-6127

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766016000000",
    "number": "1992975825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 N 2ND EAST",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834402057",
            "telephone_number": "208-359-6127",
            "fax_number": "208-359-9479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 N 2ND EAST",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401621",
            "telephone_number": "208-359-6127",
            "fax_number": "208-359-9479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE AND SPORT PYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A",
        "authorized_official_last_name": "RAWLINGS",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "208-359-6127",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "1346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805399800",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010020600",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPARTMENT OF LABOR",
            "identifier": "185556100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "T3860",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "650015362",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.